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 for using TRA for infra inguinal vessels.
Aim: Summarize 2 year experience of plain balloon angioplasty (PBA) for infra inguinal vessels by the TRA.
Pts population: 19 pts (14M) mean age 68±15 year suffering from typical intermittent claudication were included. All pts had >3 major risk factors for atherosclerosis. All pts had Ankle Brachial Index of < 0.9.
Angiographic Technique: Peripheral diagnostic angiography was undertaken via left radial artery by using 5F long 125 cm, multipurpose catheter. After lesion crossing with 300cm 0.018 wire (SV-5 Cordis) a sheath less PBA procedure was undertaken using long shaft; 180 cm (Medtronic Invatec) balloons. Post PBA result was assessed by using long multipurpose catheter. Balloon diameters were 4-6 mm, balloon length 80-150 mm. Mean balloon inflation time was 5± 2 minutes.
Angiographic data: 13/ 19 (68%) had single SFA disease and 6/19(32%) had bilateral SFA disease. 10/ 19 (53%) had multiple lesions along the SFA. 15/ 19 (79%) had mid to distal SFA pathology. Two pts had a mid-shaft CTO.
Results: Eighteen of 19 (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 or port of entry complications were noticed. All pts discharged a day after PBA.
Conclusions: Pts with SFA atherosclerotic disease can be treated safely and efficiently by long shaft balloon via TRA. In this evolving era long shaft dedicated peripheral stents are needed.
