Revealed: "Tips And Tricks" For Avoiding Access Problems When Using Large Sheath Endografts

Main Category: Cardiovascular / Cardiology
Also Included In: Medical Devices / Diagnostics
Article Date: 24 Nov 2008 - 11:00 PDT

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Iliac injury may be the most frequent fatal complication with endovascular stent graft therapy, and associated hypotension can precipitate neurologic complications. Strategies have been developed to predict, prevent, and manage these problems.

Jon S. Matsumura, M.D., Associate Professor of Surgery at the Northwestern University Feinberg School of Medicine and Attending Surgeon at Northwestern Memorial Hospital in Chicago, presented support for the point that performing iliac arteriography during sheath withdrawal can provide earlier diagnosis of a rapidly fatal iliac problem.

Dr. Matsumura also advised the VEITH Symposium physician audience to use elective conduits liberally if preoperative assessment of iliac anatomy (diameter, calcification, and tortuosity) suggests high risk of iliac injury, but also warned that the surgeon must be prepared to alter the plan if there is progressively increasing sheath resistance or need to insert multiple large devices with lower risk cases.

Above all, greater safety may be due to improved patient selection and assessment of iliac access, newer delivery systems, and more widespread practice of some of the above strategies.

VEITH SYMPOSIUM - New York, November 19th to 23rd

Now in its fourth decade, VEITH SYMPOSIUM provides vascular surgeons, interventional radiologists, interventional cardiologists and other vascular specialists with a unique and exciting format to learn the most current information about what is new and important in the treatment of vascular disease. The 5-day event features rapid-fire presentations from world renowned vascular specialists with emphasis on the latest advances, changing concepts in diagnosis and management, pressing controversies and new techniques.

VEITHsymposium is sponsored by Cleveland Clinic, Cleveland, OH.

www.veithsymposium.org

Source
Pauline T. Mayer
www.ptmhcm.com