Gani Faiz, Jammeh Momodou L, Zayed Mohamed A
Department of Surgery, School of Medicine, Washington University in St Louis, St Louis, MO.
Department of Radiology, School of Medicine, Washington University in St Louis, St Louis, MO.
J Vasc Surg Cases Innov Tech. 2023 May 3;9(3):101204. doi: 10.1016/j.jvscit.2023.101204. eCollection 2023 Sep.
Patients with critical limb threatening ischemia often present with complex segmental peripheral arterial chronic total occlusions, which might not be amenable to traditional antegrade revascularization techniques. For these patients, alternative retrograde revascularization techniques could be necessary. In the present report, we describe a novel modified retrograde cannulation technique using a bare back technique that eliminates the need for conventional tibial access sheath placement and, instead, facilitates distal arterial blood sampling, blood pressure monitoring, retrograde administration of contrast agents and vasoactive substances, and a rapid-exchange strategy. This cannulation strategy can serve as part of the armamentarium in the treatment of patients with complex peripheral arterial occlusions.
严重肢体缺血患者常表现为复杂的节段性外周动脉慢性完全闭塞，这可能不适用于传统的顺行血管重建技术。对于这些患者，可能需要采用替代性的逆行血管重建技术。在本报告中，我们描述了一种新颖的改良逆行插管技术，即裸背技术，该技术无需常规放置胫动脉鞘，而是便于进行远端动脉血样采集、血压监测、逆行注射造影剂和血管活性物质，以及采用快速交换策略。这种插管策略可作为治疗复杂外周动脉闭塞患者的手段之一。
