title: Retrograde Snare Technique to Overcome Hostile Aortic Arch Anatomy During Transcatheter Aortic Valve Implantation.
abstract: Percutaneous valve implantation is a recognized therapy for calcific aortic stenosis in those patients who are inoperable or at high surgical risk. The transfemoral approach is the most frequently used method for device delivery, but a tortuous calcific aorta and the inflexibility of large-caliber endovascular equipment can impede progress or even cause the procedure to be abandoned. Herein, the use of a technique employing a snare to safely overcome device obstruction in the aortic arch of an elderly female patient is described. The technique may be of practical value whenever any large-caliber device is obstructed in the circulation.
authors.affiliation: Karolinska Institute, Stockholm, Sweden.|Karolinska University Hospital, Stockholm, Sweden. Electronic correspondence: rodney_de_palma@icloud.com.
authors.forename: Rodney
authors.initials: R
authors.lastname: De Palma
authors.affiliation: Karolinska Institute, Stockholm, Sweden.|Karolinska University Hospital, Stockholm, Sweden.
authors.forename: Nawsad
authors.initials: N
authors.lastname: Saleh
authors.affiliation: Karolinska Institute, Stockholm, Sweden.|Karolinska University Hospital, Stockholm, Sweden.
authors.forename: Andreas
authors.initials: A
authors.lastname: Ruck
authors.affiliation: Karolinska Institute, Stockholm, Sweden.|Karolinska University Hospital, Stockholm, Sweden.
authors.forename: Magnus
authors.initials: M
authors.lastname: Settergren
mesh_terms: D000368:Aged; D001013:Aorta, Thoracic / Q000000981:diagnostic imaging / Q000473:pathology* / Q000601:surgery*; D001021:Aortic Valve / Q000000981:diagnostic imaging / Q000473:pathology* / Q000601:surgery; D001024:Aortic Valve Stenosis / Q000000981:diagnostic imaging / Q000473:pathology / Q000601:surgery*; D002114:Calcinosis / Q000000981:diagnostic imaging / Q000473:pathology / Q000601:surgery*; D000072226:Computed Tomography Angiography; D005260:Female; D006350:Heart Valve Prosthesis; D006801:Humans; D021621:Imaging, Three-Dimensional; D065467:Transcatheter Aortic Valve Replacement / Q000379:methods*