Axillary artery access for interventional procedures.
OBJECTIVE
To evaluate axillary artery access for the interventional treatment of carotid or splanchnic arteries that have angulated takeoff or complex anatomy when larger catheters (up to 9 F) are needed.


METHODS
The axillary artery approach was used to treat the left internal carotid artery (ICA) in 3 patients (2 angulated takeoffs and 1 bovine arch) and a celiac axis aneurysm. An 8-F, 45-cm-long introducer sheath was inserted for the carotid procedures, whereas a 9-F, 90-cm sheath was chosen for the celiac aneurysm. Cerebral protection and stenting were successfully performed in all carotid patients; an 8x40-mm stent-graft was implanted to exclude the celiac artery aneurysm. An 8-F vascular closure device was used in the axillary arteries; hemostasis was immediate, and no hematoma or other complications were recorded in follow-up.


CONCLUSIONS
This preliminary experience revisits the axillary approach as an alternative access route for interventional procedures. In association with a vascular closure device, this approach should be considered as a useful and safe option for those interventional procedures in which larger sheaths or catheters are required to cope with difficult arterial anatomies.
Inglese
Luigi
L
Department of Cardiovascular Radiology, Policlinico San Donato, Milan, Italy. luigi.inglese@tin.it
Lupattelli
Tommaso
T
Carbone
Giannignazio Luigi
GL
Palmisano
Domenico
D
Musto
Carmine
C
Mollichelli
Nadia
N
Medda
Massimo
M
D000783:Aneurysm / Q000601:surgery*; D017130:Angioplasty / Q000379:methods*; D001366:Axillary Artery / Q000601:surgery*; D019917:Blood Vessel Prosthesis Implantation / Q000379:methods; D002343:Carotid Artery, Internal / Q000601:surgery*; D016893:Carotid Stenosis / Q000601:surgery*; D002445:Celiac Artery / Q000601:surgery*; D006801:Humans; D015607:Stents