-
Tytuł:
-
Anatomical Considerations of Infrageniculate Popliteal Artery Puncture: Alternative Pathway for Retrograde Access After Failed Re-entry.
-
Autorzy:
-
Mennecart T; École de Santé des Armées, Bron, France.
Normand A; École de Santé des Armées, Bron, France.
Lermusiaux P; Department of Vascular and Endovascular Surgery, Hopital Louis Pradel, Bron, France; Université Claude Bernard Lyon 1 (Univ Lyon), Villeurbanne, France.
Millon A; Department of Vascular and Endovascular Surgery, Hopital Louis Pradel, Bron, France.
Della Schiava N; Department of Vascular and Endovascular Surgery, Hopital Louis Pradel, Bron, France.
Tresson P; Department of Vascular and Endovascular Surgery, Hopital Louis Pradel, Bron, France. Electronic address: .
-
Źródło:
-
Annals of vascular surgery [Ann Vasc Surg] 2020 Aug; Vol. 67, pp. 388-394. Date of Electronic Publication: 2020 Mar 21.
-
Typ publikacji:
-
Journal Article
-
Język:
-
English
-
Imprint Name(s):
-
Publication: <2007->: Netherlands : Elsevier
Original Publication: Detroit : [Published by Expansion scientifique française for Annals of Vascular Surgery, Inc. and Association pour la promotion de la chirurgie vasculaire, Paris, c1986-
-
MeSH Terms:
-
Computed Tomography Angiography*
Patient-Specific Modeling*
Catheterization, Peripheral/*adverse effects
Endovascular Procedures/*adverse effects
Popliteal Artery/*diagnostic imaging
Cadaver ; Feasibility Studies ; Humans ; Muscle, Skeletal/diagnostic imaging ; Muscle, Skeletal/injuries ; Peripheral Nerve Injuries/diagnostic imaging ; Peripheral Nerve Injuries/etiology ; Popliteal Vein/diagnostic imaging ; Popliteal Vein/injuries ; Predictive Value of Tests ; Punctures ; Retrospective Studies ; Tibial Nerve/diagnostic imaging ; Tibial Nerve/injuries ; Vascular System Injuries/diagnostic imaging ; Vascular System Injuries/etiology
-
Entry Date(s):
-
Date Created: 20200327 Date Completed: 20201102 Latest Revision: 20201102
-
Update Code:
-
20240105
-
DOI:
-
10.1016/j.avsg.2020.03.016
-
PMID:
-
32209409
-
Background: A distal approach in endovascular procedures for revascularization of lowers limbs can be considered in case of no re-entry in subintimal recanalization. The aim of this study is to evaluate the feasibility of a medial approach to the infrageniculate popliteal artery (IPA) using existing computed tomography (CT) scan simulation and punctures performed on cadavers.
Methods and Results: CT angiographies of lower extremities were used to simulate IPA puncture and puncture trajectory. Tissues damaged during the trajectory between the puncture site and the access-related injuries were analyzed. Anatomical punctures on cadaverous model were also performed. Corpses were placed in supine position, the hip in slight flexion (40°) and abduction (external rotation of 60°). A 16 G needle was used for the IPA puncture. Twelve CT angiography simulations were made. Of these 12 simulations, 9 revealed an isolated lesion of the popliteal vein and 2 isolated lesions of the tibial nerve. A lesion of the tibial nerve and the popliteal vein on the same simulation was once observed. Damage to the medial gastrocnemius muscle could not be avoided in each case. Ten punctures were performed on cadavers with technical success. There were 6 popliteal vein lesions, 3 tibial nerve lesions, and 1 case without lesion. In all cases, damage to the medial gastrocnemius muscle was seen.
Conclusions: This medial approach was feasible and is accompanied by trauma of elements of the popliteal pedicle. Preoperative CT angiography could anticipate best site of puncture and potential access-related injury.
(Copyright © 2020 Elsevier Inc. All rights reserved.)
