%0 Journal Article
%T Homemade Device to Facilitate Percutaneous Venous Arterialization in Patients With No
%A Amaia Arruabarrena
%A Ana Apodaka
%A August Ysa
%A Ederi Mikelarena
%A Juan L. Fonseca
%A Marta Lobato
%A Matthew Metcalfe
%A Roberto G¨Žmez
%J Journal of Endovascular Therapy
%@ 1545-1550
%D 2019
%R 10.1177/1526602819830983
%X Purpose: To describe a maneuver to facilitate percutaneous arteriovenous fistula creation during venous arterialization procedures in patients with no-option critical limb ischemia. Technique: Following a failed arterial recanalization attempt, a balloon catheter is passed up to the tip of the guidewire. Venous access is gained distally, a 4-F sheath is antegradely passed, and a 4-mm GooseNeck snare is advanced through it. A fluoroscopic view that overlaps the snare and the inflated balloon is obtained. If the vein remains anterior with respect to the artery, a needle is inserted across the vein, passing through the snare loop and puncturing the intra-arterial balloon. A wire is inserted and placed inside the punctured balloon. The balloon is retrieved and the wire externalized through the femoral access. A catheter is advanced antegradely over this wire from the artery into the vein. If the vein remains posterior to the artery, a needle is inserted, puncturing the balloon and thereafter the vein (crossing through the snare). A wire is inserted, captured by the snare, and externalized through the vein sheath. A catheter is finally advanced over this wire from the vein into the artery. Conclusion: This maneuver is a simple alternative to create an arteriovenous fistula during venous arterialization procedures in patients with no-option critical limb ischemia
%K balloon catheter
%K arteriovenous fistula
%K critical limb ischemia
%K desert foot
%K no-option CLI
%K plantar vein
%K snare
%K tibial artery
%K venous arterialization
%U https://journals.sagepub.com/doi/full/10.1177/1526602819830983