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ABS20191115_0012
| Peripheral Vascular Disease and Intervention | |
| Efficacy and Safety of a Novel Less Invasive Approach with Trans Ankle Intervention in Endovascular Therapy | |
| Hideyuki Takimura1, Yosuke Komatsu1, Emi Tajima1, Yukihiro Yamaguchi2, Mami Kawano1, Yukako Takimura1, Satoru Nishio1, Masatsugu Nakano1, Reiko Tsukahara1 | |
| Tokyo General Hospital, Japan1, International University of Health and Welfare, Japan2 | |
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Background:
The transfemoral approach was usually chosen for the initial access site in endovascular therapy (EVT). However, the patients needed complete rest after procedure. We performed EVT via trans ankle intervention (TAI). Approach was only single puncture at dorsal (DA) or distal posterior tibial artery (PTA). Bed rest was not needed after procedure. Our aim was to evaluate the efficacy and safety of a novel less invasive approach with TAI in EVT.
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Methods:
We performed TAI-EVT in 30 cases between August2018 and May 2019. We assessed the procedure results, safety and hemostasis results after procedure and 1 month. Under ultrasonography guidance, one of the belowthe ankle arteries was visualized and accessed, and a 5 or 6Fr. Glidesheath Slender(Terumo) was inserted. A 6Fr. guiding catheter or a guide extension catheter GUIDEZILLA¥±6Fr. PV Long (Boston) was inserted. Clinical and ultrasound assessment of the DA or PTA were performed before the procedure and at 1-month follow-up.
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Results:
Trans DA was 27 cases and trans PTA was 3 cases. Puncture was performed with ultrasonography guided in all cases. Target lesions were aorto-iliac (3 cases), formoro-poplitial (26 cases) and below the knee (1 case). 5 cases were chronic total occlusion at superficial femoral artery. All cases were successful EVT. No access-site complications were detected. Rest time after procedure was 30 minutes. In all cases, accessed artery was patented after 1 month.
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Conclusion:
The novel less invasive approach with TAI was useful and safe. TAI may also avoid many of the complications associated with the traditional femoral approach.
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