PTA of the right common iliac artery and external iliac artery in PAOD stage IIb

Puncture of the common femoral artery towards the external iliac artery. Insertion of a 6F sheath using the Seldinger technique. Advancing the guidewire under fluoroscopic control.

Tip:

Avoid puncture at the level of the inguinal ligament or higher as much as possible, because this increases the risk of rebleeding due to poor post-procedural compression of the artery.

Instillation of 2000 IU heparin-saline solution centrally and insertion of a Terumo® wire into the terminal aorta. Retrograde DSA of the external iliac artery stenosis using roadmapping technique.

Roadmapping (“Pathfinder”):

In this process, a small contrast medium bolus is applied to display the abdominal aorta as a roadmap (“street map”). This image is stored as a mask. The subsequent images are then taken without contrast medium and subtracted from the mask. In this way, for example, only a radiopaque catheter with its current position can be displayed. On the subtraction images created in this way, the bright catheter is visible over the dark abdominal aorta, and the background irrelevant to this examination is blanked out.

Advancing a pigtail catheter over the Terumo® wire and repeat DSA.