Dual Transradial Approach for Aortoiliac Occlusive Disease
Yoshimitsu Soga1, Kento Matsui1, Kenji Ando1
1Department of Cardiology, Kokura Memorial Hospital, Kitakyushu, Japan.
Insights
The dual transradial approach (TRA) offers a potential alternative for treating aortoiliac occlusive disease (AIOD). This minimally invasive technique successfully revascularized a patient with severe AIOD, demonstrating its feasibility.
Area of Science:
- Vascular Surgery
- Interventional Cardiology
- Endovascular Interventions
Background:
- The effectiveness of the dual transradial approach (TRA) for treating aortoiliac occlusive disease (AIOD) is not well-established.
- Conventional treatments often involve transfemoral approaches, but these carry specific risks and limitations.
Observation:
- A 62-year-old male patient presented with bilateral leg claudication due to severe aortoiliac occlusion.
- Medical therapy proved insufficient, necessitating endovascular revascularization.
- Computed tomography confirmed the extent of the aortoiliac occlusion.
Findings:
- A dual TRA was successfully performed, involving bilateral common iliac artery (CIA) stenting.
- The procedure utilized guiding sheaths inserted via the left and right radial arteries.
- A bare-nitinol stent was placed in each CIA without any complications, restoring blood flow.
Implications:
- Dual TRA presents a viable alternative treatment option for patients with AIOD.
- This approach may offer advantages in specific patient populations or complex anatomies.
- Further research is warranted to fully elucidate the role and long-term outcomes of dual TRA in AIOD management.
Background:
The effectiveness of the dual transradial approach (TRA) for aortoiliac occlusive disease (AIOD) remains unclear.
Case Summary:
A 62-year-old man presented with claudication in his both legs. Bilateral ankle-brachial index was decreased, and computed tomography demonstrated the aortoiliac occlusion. Because medical therapy was insufficient, revascularization was performed. A guiding sheath was inserted from the left radial artery to the distal aorta, and 2 guidewires were passed through both common iliac arteries (CIAs). After the balloon angioplasty for each CIA, new guiding sheath was additionally inserted from the right radial artery. A guidewire was advanced into the right CIA. Finally, a bare-nitinol stent was placed in each CIA from both radial arteries with no complications.
Discussion:
Although the bilateral or unilateral transfemoral approach was conventionally selected for AIOD, dual TRA could be one of the options.
Take-Home Message:
Dual TRA could be considered as an alternative treatment for AIOD.
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