A side-grooved guiding sheath as an effective treatment strategy for femoro-popliteal artery lesions.
During revascularization for chronic total occlusion (CTO) of the proximal superficial femoral artery (SFA), the guiding sheath may prolapse out of the common femoral artery (CFA) or may not be fully inserted during treatment. Therefore, we have developed a treatment strategy using a novel side-grooved guiding sheath, whereby a 5.0-Fr guiding sheath (45 cm long) with a 1.0 mm × 5.0 mm rectangular side-groove is inserted into the deep femoral artery, the side-groove is aligned with the bifurcation, and the SFA lesion treatment is performed via the side-groove. This technique provides good stability and maintains the wire's torque performance, while avoiding sheath prolapse from its position in the CFA. We have successfully treated seven cases of SFA-CTO with this guiding sheath, and did not observe any increase in complications, procedure time, or amount of contrast media (vs. the conventional procedure). Therefore, our side-grooved guiding sheath appears to be safe and effective for treating SFA-CTO, and we hope to perform additional development of this technique.
Department of Cardiovascular Medicine, Omihachiman Community Medical Center, Shiga, Japan.
Shinichiro
S
Yamaguchi
Department of Cardiovascular Medicine, Omihachiman Community Medical Center, Shiga, Japan.
Kan
K
Zen
Department of Cardiovascular Medicine, Omihachiman Community Medical Center, Shiga, Japan.
Daisuke
D
Kambayashi
D000368:Aged; D000369:Aged, 80 and over; D002908:Chronic Disease; D057510:Endovascular Procedures / Q000295:instrumentation*; D004867:Equipment Design; D005260:Female; D005263:Femoral Artery / Q000000981:diagnostic imaging; D006801:Humans; D008297:Male; D008875:Middle Aged; D058729:Peripheral Arterial Disease / Q000000981:diagnostic imaging / Q000628:therapy*; D011150:Popliteal Artery / Q000000981:diagnostic imaging; D015641:Radiography, Interventional; D016896:Treatment Outcome; D062666:Vascular Access Devices
chronic total occlusion; lesion treatment; superficial femoral artery