Vascular Surgery Department, Hospital de Cruces, Barakaldo, País Vasco, Spain.
Vascular Surgery Department, Lister Hospital, Stevenage, Hertfordshire, UK.
J Endovasc Ther. 2020 Jun;27(3):505-508. doi: 10.1177/1526602820913981. Epub 2020 Mar 20.
To present a simple method to avoid favored passage of a guidewire into the profunda femoris artery (PFA) after antegrade puncture of the common femoral artery. A 6-F conventional introducer sheath with a radiopaque distal marker is placed on the nurse's table with its side port orientated to the 12 o'clock position. A small (2-2.5 mm) oval fenestration is created on the superior aspect of the sheath about 3 cm from its tip with a size 11 surgical blade. The modified introducer is passed over the angled 0.035-inch guidewire into the PFA and gently retrieved until the tip marker is ~3 cm from the femoral bifurcation. The dilator is removed, and the guidewire is withdrawn to the level of the fenestration, manipulated through it, and advanced further into the superficial femoral artery under fluoroscopic guidance. When repeated passage of the guidewire down the PFA persists despite conventional manipulation of the wire or needle, an on-site modification of the sheath is an easy alternative approach for the catheterization of the superficial femoral artery.
为避免经股动脉顺行穿刺后导丝易进入股深动脉（PFA），我们介绍一种简单的方法。将带有不透射线远端标记的 6-F 常规导入鞘置于护士台上，其侧端口位于 12 点钟位置。用 11 号手术刀在鞘的上表面距尖端约 3 厘米处做一个小的（2-2.5 毫米）椭圆形窗。将改良的导入器沿 0.035 英寸的导丝穿过 PFA，并轻轻取出，直到尖端标记距股分叉处约 3 厘米。取出扩张器，将导丝撤回至窗孔水平，通过窗孔进行操作，并在透视引导下将导丝进一步推进至股浅动脉。如果反复尝试通过 PFA 引导导丝，但常规操作导丝或针仍不成功，那么对鞘进行现场修改是一种简单的替代方法，可用于股浅动脉的导管插入术。
