PMC6250015_01
Questionable high stick with the sheath tip about to come out of the CFA.
CRIC2018-2041643.001.jpg
PMC6250015_01_CRIC2018-2041643.001.jpg
fig1
A wire passed through the sheath in order to secure access.
CRIC2018-2041643.002.jpg
PMC6250015_01_CRIC2018-2041643.002.jpg
fig2
IEA by sticking the U portion of the IEA, but due to the high risk, a wire was passed through the sheath in order to secure access (Figure 2). Immediate access was obtained through the contralateral groin (Figure 3) then a balloon over the wire was passed beyond the original sheath tip (Figure 4), and then the sheath was slowly pulled back while contrast was injected.
Access obtained from contralateral femoral artery.
CRIC2018-2041643.003.jpg
PMC6250015_01_CRIC2018-2041643.003.jpg
fig3
IEA by sticking the U portion of the IEA, but due to the high risk, a wire was passed through the sheath in order to secure access (Figure 2). Immediate access was obtained through the contralateral groin (Figure 3) then a balloon over the wire was passed beyond the original sheath tip (Figure 4), and then the sheath was slowly pulled back while contrast was injected.
A balloon over the wire was passed beyond the original sheath tip.
CRIC2018-2041643.004.jpg
PMC6250015_01_CRIC2018-2041643.004.jpg
fig4
IEA by sticking the U portion of the IEA, but due to the high risk, a wire was passed through the sheath in order to secure access (Figure 2). Immediate access was obtained through the contralateral groin (Figure 3) then a balloon over the wire was passed beyond the original sheath tip (Figure 4), and then the sheath was slowly pulled back while contrast was injected.
Angiogram showed that the sheath was inserted through the U-shaped portion of the IEA.
CRIC2018-2041643.005.jpg
PMC6250015_01_CRIC2018-2041643.005.jpg
fig5
IEA (Figure 5) and that the IEA had no dissection nor laceration. In the end, a closure device (Mynx) was applied to the access site and hemostasis was achieved.