Utility and feasibility of ultrasound‐guided access in patients with critical limb ischemia

Abstract

US guided access is a feasible and safe procedure that can aid in accessing vascular conduits in patients with CLI. Applying this technique across the board in CLI patients decreases the risk of immediate complications and facilitates accessing tibial arteries.

Below-the-Knee Retrograde Access for Peripheral Interventions: A Systematic Review

“…Finally, studies that did not include ≥10 punctures via the BTK arteries were excluded, leaving 19 articles for data abstraction. 5,12,14,15,19–33…”

“…5,23,24,26 One study 14 described the use of a 2.9-F microsheath. A 4-F sheath was used in 7 studies, 12,19,22,27,29,30,33 of which 2 studies 27,33 allowed later use of a 6-F sheath to facilitate retrograde interventions. The most common guidewires were 0.014-inch and 0.018-inch; several studies allowed for an upsize to 0.035-inch wires, 23,29 dedicated CTO wires, 5,26,30 or crossing devices.…”

“…The most common guidewires were 0.014-inch and 0.018-inch; several studies allowed for an upsize to 0.035-inch wires, 23,29 dedicated CTO wires, 5,26,30 or crossing devices. 19,22…”

“…Based on the title, 9912 articles were eliminated (Figure 1). Of the 483 articles left for abstract analysis, 3 studies 15,19,20 showed potential overlap; contact with the lead author confirmed no overlap in patients. The 53 remaining articles were cross-referenced, but no other relevant retrograde access studies were found.…”

“…5 The PTA was punctured at or distal to the ankle. 5,23 Ultrasound was used to obtain access in 10 studies, 12,15,19,20,23,24,27,29,30,33 6 allowed for a combination of ultrasound and fluoroscopy, 14,21,22,28,31,32 and 3 studies 5,25,26 described punctures using only fluoroscopy guidance. Sheathless access was performed in 4 studies.…”