Transbrachial and Femoral Artery Approach Endovascular Therapy for Flush Infrarenal Aortic Occlusion

Abstract

Transbrachial and femoral artery approach endovascular therapy for FIAO offers an alternative to surgical reconstruction with immediate outcomes.

Strategies for managing aortoiliac occlusions: access, treatment and outcomes

“…The volume of contrast should also be minimized, especially in these patients. Rates of renal failure are low after iliac stenting; however, in the presence of an aortic occlusion, the rates range from 0 to 15%, with rare instances of progression to dialysis dependency [7,10,38,65]. In our series, both the patients who progressed to dialysis had normal renal function preoperatively, one with a solitary kidney and the other with known coronary disease who developed cardiogenic shock.…”

Efficacy and Safety of Transbrachial Access for Iliac Endovascular Interventions

“…Because of the unique anatomic characteristics of iliac vessels, a dual arterial access approach can often be required, 11,18 not only in cases of primary brachial artery access but also when a TFA is the first choice, especially for the treatment of extensive disease. 6,11,12 Up to now, there has been limited experience with the use of more sophisticated endovascular devices than stents and balloon catheters in a transbrachial setting. The relatively small vessel diameter makes percutaneous brachial artery access unsuitable for materials requiring >6-F sheaths, for example, atherectomy catheters, covered stents.…”

“…1 The preferential use of the transradial over transfemoral access (TFA) emerged as a potential modifier of mortality in patients with acute coronary syndromes, 2 and the transradial approach was associated with a lower incidence of major adverse events in numerous large-scale studies. [1][2][3] In the peripheral arteries, the adjunctive use of an upper extremity access to TFA expanded the effectiveness of endovascular therapy, [4][5][6][7][8] whereas the application of an antegrade approach is essential in many procedures for complex endovascular aneurysm repair. 9 In terms of iliac artery disease, brachial artery access can play an important role, particularly in the presence of severe aortoiliac disease 6,8,[10][11][12][13][14] or in patients with lesion anatomy unfavorable for an inguinal approach.…”

Antiplatelet and anticoagulant for prevention of reocclusion in patients with atrial fibrillation undergoing endovascular treatment for low extremity ischemia

“…(II) In addition, thrombus was successfully attenuated with CDT or mechanical thrombectomy. And more, thrombolysis is not only feasible for acute patients, but also for acute on chronic cases (13).…”

“…After May 2015, thrombectomy were performed using 6/8F Straub Rotarex to reduce ischemic symptoms and a few patients who were revealed a residual thrombus by angiography underwent catheter-directed thrombolysis (CDT). Complete details of the urokinase and unfractionated heparin infusion and laboratory monitoring were according to previously studies (13).…”