July 2015 Q & A
Question: 2 Infusion Catheters, 2 Graft Punctures for Access of the Same Leg
The patient has a left femoral to below-knee popliteal artery bypass graft and a left abandoned bypass graft. A micropuncture needle was advanced in a midline retrograde fashion and a sheath placed. A pelvic angiogram shows occlusion of the bypass graft and a 10 cm infusion Cragg-McNamara infusion catheter is placed and positioned across the proximal arterial anastomosis. Then under direct ultrasound guidance, a micropuncture needle was advanced into the proximal graft in an antegrade fashion, then a sheath was placed, followed by lower extremity angiography.