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Ipsilateral Protection and Bailout for Large-Bore Access.

Amit Shah, Aadil Lodhi, Michael Bianco

  • 1Division of Cardiology, Robert Packer Hospital, 1 Guthrie Square, Sayre, PA, 18840 USA. ekaluski@gmail.com or edo.kaluski@guthrie.org.

The Journal of Invasive Cardiology
|August 2, 2021
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Summary

This study refines ipsilateral wire protection for large-bore femoral access, offering a cost-effective bailout strategy for transcatheter aortic valve replacement without needing contralateral access.

Keywords:
ipsilateral wiretranscatheter aortic valve replacementtransradial

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Area of Science:

  • Cardiovascular Interventions
  • Vascular Surgery
  • Medical Device Technology

Background:

  • Large-bore femoral access is crucial for procedures like transcatheter aortic valve replacement.
  • Managing arteriotomy sites during large-bore access can be challenging.
  • Existing methods may require contralateral femoral access, which is not always feasible.

Purpose of the Study:

  • To describe refined techniques for ipsilateral wire protection and bailout.
  • To evaluate the efficacy of ipsilateral wiring for arteriotomy site protection.
  • To present a cost-effective alternative to contralateral access strategies.

Main Methods:

  • Detailed description of the ipsilateral wire protection and bailout technique.
  • Application in large-bore femoral access, particularly for transcatheter aortic valve replacement.
  • Comparative analysis with conventional contralateral femoral and transradial wire protection.

Main Results:

  • Ipsilateral wire protection provides effective arteriotomy site management.
  • The technique is cost-effective, requiring no additional expenses.
  • It serves as a viable alternative when contralateral access or crossover is not feasible.

Conclusions:

  • Refined ipsilateral wire protection is a valuable strategy for large-bore femoral access.
  • This method enhances safety and efficiency in transcatheter aortic valve replacement.
  • It offers a practical solution, especially in challenging anatomical or procedural scenarios.