A 6F sheath was inserted into right femoral artery by antergrade approach. After angiograpy, 4F shuttle was inserted via sheath for the below the knee intervention. We passed the CTO lesion of ATA using 0.014 Fielder XT wire with over-the-wire balloon. After confirming the true lumen via over-the-wire balloon( Movie 4), 0.018 V-18 control wire was inserted and balloon angioplasty for dorsalis pedis artery and the ATA was performed with Fox 2.0 x 40mm, SLEEK 2.0 x 220mm, SLEEK 2.5 x 220mm by stage (Figure 1). After balloon angioplasty, ATA and dorsalis pedis flow was getting better, but far distal blood flow to the wound site was not sufficient. So we tried wiring to the digital artery with Fielder XT wire and performed balloon angioplasty with coronary 1.5 x 15mm balloon (Figure 2). Final angiogram showed a successful result and good blood supply to the right foot ( Movie 5, Movie 6, Movie 7). |
Leave a comment