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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
PubMed

Insights

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.

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.

Keywords:
limb ischemiaperipheral arterial diseaseperipheral intervention

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