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Obtaining True Lumen Access in Aortic Dissections with Iliac Extension 

Obtaining True Lumen Access in Aortic Dissections with Iliac Extension
Chapter:
Obtaining True Lumen Access in Aortic Dissections with Iliac Extension
Author(s):

Roshni A. Parikh

, and David M. Williams

DOI:
10.1093/med/9780199986071.003.0012
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date: 30 September 2020

Aortic dissection resulting in lower extremity ischemia is an emergent condition requiring urgent endovascular treatment of the aorta and iliofemoral arteries to restore blood flow to the lower extremities. This chapter describes the management, applications, challenges, and potential complications when obtaining bilateral true lumen access during the urgent endovascular treatment of lower extremity ischemia after an aortic dissection. Most interventions require retrograde access to the true lumen; however, if one of the common femoral arteries is dissected, then retrograde access can be a challenge. Utilizing the contralateral true lumen, retrograde access can be confidently obtained through the true lumen of a dissected artery. This chapter illustrates the steps involved in successfully obtaining bilateral retrograde access to the common femoral arteries when these challenging cases arise.

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