Division of Cardiology, Morinomiya Hospital.
J Atheroscler Thromb. 2021 Apr 1;28(4):349-355. doi: 10.5551/jat.57083. Epub 2020 Jun 20.
This study aims to describe the feasibility and safety of direct occluded vessel puncture as a new access site for complex peripheral artery occlusive disease.
Eleven consecutive patients with symptomatic peripheral artery disease underwent endovascular therapy using the direct occluded vessel puncture technique. The occluded vessel was punctured using a dedicated 20 G needle and the Hi-Torque Command 18 ST guidewire under duplex echo or fluoroscopic guidance, and a 6 Fr sheath was then inserted. Hemostasis was achieved with the Exoseal Vascular Closure Device.
Direct occluded vessel puncture was achieved in 10 of 11 cases (90.9%), and procedural success was achieved in all cases. There were no in-hospital deaths or any complications, including bleeding, pseudoaneurysms, thrombosis, or surgical conversion.
The direct occluded vessel puncture technique using a 20 G needle and the Hi-Torque Command 18 ST is feasible and safe. This technique may also be used as an alternative option when there are no appropriate approach sites.
本研究旨在描述直接闭塞血管穿刺作为一种新的复杂外周动脉闭塞性疾病入路的可行性和安全性。
11 例有症状的外周动脉疾病患者采用直接闭塞血管穿刺技术进行血管内治疗。在双功超声或透视引导下，使用专用的 20G 针和 Hi-Torque Command 18 ST 导丝穿刺闭塞血管，然后插入 6Fr 鞘。使用 Exoseal 血管闭合装置止血。
11 例（90.9%）中 10 例成功进行了直接闭塞血管穿刺，所有病例均获得了手术成功。无院内死亡或任何并发症，包括出血、假性动脉瘤、血栓形成或手术转换。
使用 20G 针和 Hi-Torque Command 18 ST 的直接闭塞血管穿刺技术是可行和安全的。当没有合适的入路时，该技术也可以作为一种替代选择。
