Procedure Performed:
1. Abdominal aortogram with non-selective renal angiogram.
2. Bilateral iliac angiogram.
3.Selective left lower extremity angiogram with a sheath placed into the left common femoral artery.
4. Selective right iliofemoral angiogram with a sheath placed into the right common femoral artery.
5. PTA of totally occluded left iliac artery using 6.0 x 40 mm long Foxcross balloon.
6. Stenting of the left common iliac and external iliac vessel using 8mm x 59 mm Omnilink.
Description of Procedure:
A 5-French Sheath was inserted into the right common femoral artery after access was gained using Sinlge Puncture Modified Seldinger Technique.
A 5 French Omni Flush Cathetetr was advanced into descending abdominal aorta just above the level of the origin of the iliac arteries.
10 cc of contract was given using digital subtraction and showed that the abdominal aorta was calcified with mild narrowing. There are two renal arteries on the right side which appeared patent. On the left side there appeared single left renal artery.
The Omni Flush Catheter was pulled back just to above the origin of the iliace arteries and 10 cc of contrast was again injected using digitial subtraction and showed the right common and external iliac artery and the right internal iliac artery was patent .. There was a median sacral artery which was patent. Left common iliac artery was completely occluded at its origin and reconstituted distally in the left external iliac artery very faintly. Left SFA and left profunda were faintly visulalized. There was very slow runoff to the foot via the patient left SFA, popliteal and below the knee vessels.
Because of pt's symptoms of lifestyle limiting claudication it was decided to recanalize the totally occluded left common iliac and external iliac artery. For that a 5 French Sheath was inserted into the left common femoral artey using Modified Seldinger Technique.
A 5 French Glidewire was used over Quickcross Spectranetics Catheter which was 90 cm long. The lesion was easily able to be crossed with a Glidewire and Spectranetics. The catheter was placed into the descending abdominal aorta just above the origin of the iliac arteries. 5-10 cc of contrast was then injected into the aorta via the Spectranetics catheter and confirmed that we were in the true lumen in the descending abdominal aorta.
A 5 French Sheath on the left side was upsized to a 6 Frech Sheath. Balloon dilatation of a totally occluded left common iliac and external iliac artery was performed with the help of the Foxcross PTA balloon, this was 6mm X 4mm on ..80 shaft. This was dilated up to about 6 atmosphere. There was no residual stenosis of about 60-70% and hence the vessel was stented with 8.0 x 59 mm Omnilink Balloon expandable stent up to 9 atmosphere improving the lumen size from 100% occlusion before to 0% residual.
Both the left iliofemoral and the right iliofemoral angiograms was performed. The catheters were removed. The patient was transfered to the holding area in a stable condition.
37221-LT
75716-26-59
75625-26
Thanks!
1. Abdominal aortogram with non-selective renal angiogram.
2. Bilateral iliac angiogram.
3.Selective left lower extremity angiogram with a sheath placed into the left common femoral artery.
4. Selective right iliofemoral angiogram with a sheath placed into the right common femoral artery.
5. PTA of totally occluded left iliac artery using 6.0 x 40 mm long Foxcross balloon.
6. Stenting of the left common iliac and external iliac vessel using 8mm x 59 mm Omnilink.
Description of Procedure:
A 5-French Sheath was inserted into the right common femoral artery after access was gained using Sinlge Puncture Modified Seldinger Technique.
A 5 French Omni Flush Cathetetr was advanced into descending abdominal aorta just above the level of the origin of the iliac arteries.
10 cc of contract was given using digital subtraction and showed that the abdominal aorta was calcified with mild narrowing. There are two renal arteries on the right side which appeared patent. On the left side there appeared single left renal artery.
The Omni Flush Catheter was pulled back just to above the origin of the iliace arteries and 10 cc of contrast was again injected using digitial subtraction and showed the right common and external iliac artery and the right internal iliac artery was patent .. There was a median sacral artery which was patent. Left common iliac artery was completely occluded at its origin and reconstituted distally in the left external iliac artery very faintly. Left SFA and left profunda were faintly visulalized. There was very slow runoff to the foot via the patient left SFA, popliteal and below the knee vessels.
Because of pt's symptoms of lifestyle limiting claudication it was decided to recanalize the totally occluded left common iliac and external iliac artery. For that a 5 French Sheath was inserted into the left common femoral artey using Modified Seldinger Technique.
A 5 French Glidewire was used over Quickcross Spectranetics Catheter which was 90 cm long. The lesion was easily able to be crossed with a Glidewire and Spectranetics. The catheter was placed into the descending abdominal aorta just above the origin of the iliac arteries. 5-10 cc of contrast was then injected into the aorta via the Spectranetics catheter and confirmed that we were in the true lumen in the descending abdominal aorta.
A 5 French Sheath on the left side was upsized to a 6 Frech Sheath. Balloon dilatation of a totally occluded left common iliac and external iliac artery was performed with the help of the Foxcross PTA balloon, this was 6mm X 4mm on ..80 shaft. This was dilated up to about 6 atmosphere. There was no residual stenosis of about 60-70% and hence the vessel was stented with 8.0 x 59 mm Omnilink Balloon expandable stent up to 9 atmosphere improving the lumen size from 100% occlusion before to 0% residual.
Both the left iliofemoral and the right iliofemoral angiograms was performed. The catheters were removed. The patient was transfered to the holding area in a stable condition.
37221-LT
75716-26-59
75625-26
Thanks!