[MO-20] Presentation Awards
SFA puncture can be safe option for EVT using vascular closure device (Exoseal®) under the fluoroscopic guidance
Objectives: It has been recognized that CFA is the best access site for EVT because compression is effective as it is supported by the stiff anatomical structure of born from its back. Hemostasis after superficial femoral artery puncture (SFAP) is thought to increase frequency in complications. However, as EVT is indicated so widely nowadays, there are some cases which we can’t use the CFA due some reasons i.e. highly calcified or obstructed CFA, after endarterectomy etc. We can puncture SFA easily and get safe hemostasis after using vascular closure device (Exoseal®) under the fluoroscopic guidance.
Patient and Method: 18 patients received EVT by SFAP between July 2017 and November 2018. Target legions are as below: 10 antegrade puncture cases including 7 treated for below the knee legions, the other is treated for SFA legions. 8 retrograde puncture cases including 1 for abdominal aorta, the other is iliofemoral artery. The reasons for the SFAP are bellow: after endarterectomy of CFA are 8, complete occlusion of CFA are 3, highly calcified CFA are 3, high take off DFA are 2 and aneurysmal CFA are 2. Average puncture site of SFA was performed 6.7cm (3.1cm~ 12.7cm)from the lower edge of the femoral head. After EVT, we performed arterial angiography of puncture site for confirming the precise point of insertion of the sheath. Then we set the closure device. The delivery of hemostasis plaque was carried out under the fluoroscopic guidance.
Result: Under this method, we get complete hemostasis for all patients and no pseudoaneurism.
Conclusion: SFAP can be safe and useful option for the cases which should avoid the CFA puncture, if the fluoroscopic guide method of the closure device (Exoseal®) are adopted.
Patient and Method: 18 patients received EVT by SFAP between July 2017 and November 2018. Target legions are as below: 10 antegrade puncture cases including 7 treated for below the knee legions, the other is treated for SFA legions. 8 retrograde puncture cases including 1 for abdominal aorta, the other is iliofemoral artery. The reasons for the SFAP are bellow: after endarterectomy of CFA are 8, complete occlusion of CFA are 3, highly calcified CFA are 3, high take off DFA are 2 and aneurysmal CFA are 2. Average puncture site of SFA was performed 6.7cm (3.1cm~ 12.7cm)from the lower edge of the femoral head. After EVT, we performed arterial angiography of puncture site for confirming the precise point of insertion of the sheath. Then we set the closure device. The delivery of hemostasis plaque was carried out under the fluoroscopic guidance.
Result: Under this method, we get complete hemostasis for all patients and no pseudoaneurism.
Conclusion: SFAP can be safe and useful option for the cases which should avoid the CFA puncture, if the fluoroscopic guide method of the closure device (Exoseal®) are adopted.