Long balloon, Long Shaft for SFA Intervention Using Trans Radial Aproach

Background: Trans radial approach (TRA) is a well-established technique for diagnosis and treating coronary disease, however anatomical,technical and equipment related obstacles are still exist while using TRA for infra inguinal vessels.

Aim: Summarize 3 year experience of plain balloon angioplasty (PBA) for infra inguinal vessels by the TRA.

Pts population: 22 pts (14M) mean age 70±15 year with intermittent claudication were included. All pts had Ankle Brachial Index of < 0.9 in the affected leg.

Angiographic Technique: peripheral diagnostic angiography was undertaken via left radial artery by using 5F long 125 cm, multipurpose (MP) catheter. 6F long MP guiding catheter was used only in 12/22 (55%) of the pts . Lesion crossing used by 300cm 0.018 wire (SV-5 Cordis) .Lesion dilatation was undertaken using 180 cm long shaft system (Medtronic Invatec). Post PBA result was assessed by using long MP catheter. Balloon diameters were 4-6 mm, balloon length 80-150 mm. Mean balloon inflation time was 6± 2 minutes.

Angiographic data: 15/ 22 (68%) had single SFA disease and 7/22 (32%) had bilateral SFA disease. 10/ 22 (45%) had multiple lesions along the SFA. 17/ 22 (77%) had mid to distal SFA pathology. Two pts had a mid-shaft CTO.

Results: 21/ 22 (95%) pts underwent successful technical procedures .One pts with CTO had a failed wire crossing .Mean lesion narrowing before and after procedure was 80+ 15% and 30+10% respectively. No flow limiting dissection nor port of entry complications were noticed. All pts discharged a day after procedure

Conclusions: Pts with SFA atherosclerotic disease can be treated safely and efficiently by long shaft, long balloons via TRA. In this evolving era long shaft peripheral stents are needed.