Cardiology

Endovascular Skills: Guidewire and Catheter Skills for by Peter Schneider

By Peter Schneider

Endovascular abilities has been the go-to consultant for education in minimally invasive vascular surgical procedure for the final 4 years, and now could be thoroughly up-to-date and revised.

Well-organized development of themes mirrors the clinician’s personal development of ability development, in an easy-to-read textual content, supported via transparent, simplistic line drawings, which make for a well-illustrated useful consultant for the pro and amateur practitioner alike.

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Extra resources for Endovascular Skills: Guidewire and Catheter Skills for Endovascular Surgery

Sample text

B) The needle is withdrawn 1 to 2 mm and the guidewire is passed again. 24 Chapter 3 A C D B Fig. 6 Incorrect femoral artery punctures. Entry site complications result from poorly placed femoral artery punctures. (A) Proximal superficial femoral artery puncture is too low and may cause puncture site thrombosis. The proximal superficial femoral artery is frequently the site of significant plaque formation. (B) A proximal deep femoral artery entry is difficult to compress and may result in hemorrhage.

Getting In: Percutaneous Vascular Access 41 Seldinger S. Catheter replacement of the needle in percutaneous arteriography. Acta Radiol 1953; 39:368–376. Spies J, Bakal C, Burke D, et al. Standards for arteriography in adults. J Vasc Intervent Radiol 1993; 4:385–395. Valji K. Standard angiographic and interventional techniques. In: Valji K, ed. Vascular and Interventional Radiology. Philadelphia, PA: W. B. Saunders, 1999:12–17. 4 Basic Sheath Access Basic Access Site Step-by-Step Intial Maneuvers to Secure the Access How Do You Place a Sheath?

PLAN OF ATTACK: GUIDEWIRE WILL NOT PASS THROUGH THE NEEDLE 1. If the tip of the entry needle is against the posterior wall of the artery, withdraw the needle 1 to 2 mm very slowly while gently attempting to pass the guidewire (Fig. 5). As the needle pulls back far enough, the guidewire will pass easily. 2. If the guidewire encounters a common femoral artery lesion, irregular posterior wall plaque may be disrupted, form a dissection plane, or embolize. Do not force the guidewire. 3. Withdraw the guidewire to ensure that the needle tip is still intraarterial and that backbleeding is pulsatile.

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