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Related Experiment Video

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Large bore occlusive sheath management.

Amir Kaki1, M Chadi Alraies1, Marvin Kajy1

  • 1Wayne State University School of Medicine, Detroit Medical Center, Detroit, Michigan.

Catheterization and Cardiovascular Interventions : Official Journal of the Society for Cardiac Angiography & Interventions
|January 29, 2019
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Interventional cardiologists can manage large bore access complications like thrombosis and limb ischemia using specific techniques. These strategies ensure continued hemodynamic support and maintain access without compromising extremity perfusion.

Keywords:
limb ischemiaperipheral arterial diseaseperipheral intervention

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Area of Science:

  • Interventional Cardiology
  • Vascular Surgery

Background:

  • Complex interventional cardiology procedures like TAVR, EVAR, and MCS device deployment necessitate large bore access.
  • Large bore access increases the risk of vascular complications, including thrombosis and limb ischemia.

Purpose of the Study:

  • To describe management strategies for occlusive sheaths encountered with large bore access in upper and lower extremities.
  • To provide interventional cardiologists with methods to handle these complications effectively.

Main Methods:

  • Description of techniques for managing occlusive sheaths associated with large bore access.
  • Includes strategies such as introducer sheath peeling and creation of internal/external bypass circuits.

Main Results:

  • Successful management of occlusive sheaths allows for prolonged hemodynamic support.
  • Maintained large bore sheath access is achievable without compromising extremity perfusion.

Conclusions:

  • Effective management strategies are crucial for interventional cardiologists performing large bore access procedures.
  • The described techniques offer a means to overcome vascular complications, ensuring patient safety and procedural success.