Ex-vivo percutaneous bypass: Limb perfusion in the setting of occlusive large bore sheath. 

 -  2019 
<br/><br/>Available online from MWHC library: 1996 - present, Available in print through MWHC library: 1996 - 2006 
<br/><br/> Copyright (c) 2018 Wiley Periodicals, Inc.  Successful cardiac catheterization procedure begins with safe vascular access and ends with effective hemostasis after equipment removal. These new and advanced technologies in the cath lab require large-bore arterial accesses. Large-bore sheaths are associated with blood flow obstruction resulting in limb ischemia. In this case we present a 48-year-old woman was admitted NSTEMI and cardiogenic shock requiring mechanical circulatory support. Selective left common iliac angiography demonstrated obstructive flow at the level of the left CFA (access site). Therefore, ipsilateral bypass circuit was done. The current case illustrates the utility of a temporary ex-vivo bypass circuit to preserve limb perfusion in the presence of an occlusive large bore sheath. The technique permits sufficient hemodynamic support while maintaining limb perfusion and can be used for any occlusive large bore sheath. 
<br/><br/><br/>English 
<br/><br/><label>ISSN: </label>1522-1946 
<br/><br/><label>Standard No.: </label>10.1002/ccd.28022 [doi] 
<br/><br/><label>Subjects--Topical Terms: </label><br/>*Cardiac Catheterization/is [Instrumentation]<br/>*Catheterization, Peripheral/is [Instrumentation]<br/>*Femoral Artery/pp [Physiopathology]<br/>*Ischemia/pc [Prevention & Control]<br/>*Non-ST Elevated Myocardial Infarction/th [Therapy]<br/>*Peripheral Arterial Disease/pp [Physiopathology]<br/>*Shock, Cardiogenic/th [Therapy]<br/>*Vascular Access Devices<br/>Cardiac Catheterization/ae [Adverse Effects]<br/>Catheterization, Peripheral/ae [Adverse Effects]<br/>Equipment Design<br/>Female<br/>Femoral Artery/dg [Diagnostic Imaging]<br/>Humans<br/>Ischemia/pp [Physiopathology]<br/>Middle Aged<br/>Non-ST Elevated Myocardial Infarction/di [Diagnosis]<br/>Non-ST Elevated Myocardial Infarction/pp [Physiopathology]<br/>Peripheral Arterial Disease/dg [Diagnostic Imaging]<br/>Punctures<br/>Regional Blood Flow<br/>Shock, Cardiogenic/di [Diagnosis]<br/>Shock, Cardiogenic/pp [Physiopathology]<br/>Treatment Outcome<br/>Vascular Patency
<br/><br/><label>Subjects--Geographic Terms: </label><br/>MedStar Washington Hospital Center
<br/><br/><label>Index Terms--Occupation: </label><br/>Medicine/Internal Medicine
<br/><br/><label>Index Terms--Function: </label><br/>Case Reports