A 4Fr sized sheath and a 6Fr sized sheath were inserted into the right and left femoral arteries, respectively. An Athetlteruby hard 0.014 inch wire and a Conquest pro-12 0.014 inch wire were used attempting to pass through the left common iliac artery lesion via antegrade and retrograde approach. But it was difficult to pass through the lesion. There was a dissection on follow up angiography ( Movie 1). So another 5Fr sized sheath was inserted into the left brachial artery. An Athetlteruby hard 0.014 inch wire was inserted into left brachial artery and passed through the lesion. The Virtual Histology was performed. There were many thrombi at the lesion. After that, this Athetlteruby wire was replaced with a Floppy BMW 0.014 inch wire (Figure 2). Pre-ballooning with SLEEK 3.0 x 60 mm sized balloon upto 3.0 (6 atm) was performed at left common iliac artery ( Movie 2). And then, thrombectomy was done three times. A huge red thrombus was suctioned. Additional ballooning with Aviator 6.0 x 30mm sized balloon upto 5.83 (8 atm) was performed at lesion site. And then, stenting with two Zilver 7.0 x 100mm sized stents was performed. Post-deployment balloon dilatation was performed, sequentially ( Movie 3). Final angiogram showed well-positioned stent in left common iliac artery ( Movie 4). |
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