Translumbar coronary and brachiocephalic arteriography using a modified Desilets-Hoffman sheath

A translumbar sheath is described that is suitable for performance of selective coronary and brachiocephalic arteriography when the extremity arteries are blocked. The sheath has been adapted to a needle and catheter, which are introduced as a unit into the aorta at the T-12 level. With the needle and catheter removed, the sheath can be used safely to exchange catheters for left ventriculography and selective studies of branches of the thoracic aorta without excessive retroperitoneal bleeding.