Percutaneous catheterization of aortofemoral grafts

✍ Scribed by Drew, Denis W.

• Book ID: 101826700
• Publisher: John Wiley and Sons
• Year: 1980
• Tongue: English
• Weight: 50 KB
• Volume: 6
• Category: Article
• ISSN: 0098-6569
• DOI: 10.1002/ccd.1810060215

✦ Synopsis

The article on catheter tip entrapment by aortofemoral bypass grafts by Doctors Lipoff and Killam [I] was interesting and stimulated me to add a few thoughts on this subject. I have performed cardiac catheterization by the Seldinger technique primarily with Cordis preformed catheters on a number of patients who have had an aortofemoral bypass graft present and have noticed certain peculiarities common to these patients. First, I have noticed that it is usually difficult, if not impossible, to insert the same French size catheter as the vessel dilator used. I therefore routinely use an 8 French vessel dilator and insert a 7 French catheter. This has not resulted in any bleeding during catheterization. Second, I have noticed that, although the catheters may advance with moderate ease, the problem usually occurs in retracting the catheter, which suggests a one-way valve effect at the catheter puncture site in the graft prosthesis. I agree with the authors' speculation that insertion of an arterial sheath may prevent this problem; however, I would be worried that the sheath would not be strong enough to maintain it's integrity upon removal. There is the possibility, of course, that the sheath may collapse sufficiently to allow removal, but if anyone has had experience with using an arterial sheath in an aortofemoral graft, I would be interested in their results. I have also noticed that there is remarkably little bleeding following removal of the catheter, suggesting that the one-way valve effect may have effectively occluded the puncture site.