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CVIR Endovascular
Fig. 2 | CVIR Endovascular

Fig. 2

From: The “Needle bypass” technique: Percutaneous anatomical bypass with needle rendezvous for patients with peripheral arterial disease that have no other surgical options

Fig. 2

The treatment process of Needle Bypass technique. A. An antegrade 6-Fr guiding sheath was inserted over the pull-through guidewire into the body between the puncture sites. B. The third 18-gauge needle punctured from the proximal site through the space (blue frame), which was formed by a 4.0 × 20-mm semicompliant balloon dilatation, into the SFA lumen where a retrograde 4-Fr catheter was inserted. C. After the guidewire externalization with 0.014-in. guidewire between the third needle and 4-Fr catheter, the 4-Fr catheter was advanced into the space (blue frame) on a 0.035-in. guidewire and together advanced into the antegrade 6-Fr guiding sheath. D. After removal of the 6-Fr guiding sheath, a 0.014-in. guidewire inside the 4-Fr catheter was advanced into an antegrade 7-Fr guiding sheath from the left CFA as a contralateral approach

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