The needle rendezvous technique, which uses a needle instead of a microcatheter for EVT to the peripheral artery, allows for safe and quick guidewire externalization, according to a presentation by Dr. Masanaga Tsujimoto of the Sapporo Cardiovascular Clinic at the Speaker's Corner Session of LINC 2022.
The Novel Guidewire Externalization Technique using a Needle without Inserting Microcatheter – Needle Rendezvous Technique－
The study examined the safety and efficacy of the needle rendezvous technique in 12 patients who underwent EVT from August 2020 to February 2022 at the Sapporo Cardiovascular Clinic.
Heavily calcified and occluded lesions are delivered devices difficulty and guidewire externalization adding a retrograde system is one of the solutions for this kind of problem. In such cases, the needle rendezvous technique is a technique in which a needle is punctured from the distal portion and a guide wire from antegrade is inserted into the needle hole to achieve externalization. The 18G and 20G needle hole sizes are larger than microcatheter tips that fit 0.014" and 0.018", respectively, allowing for easier rendezvous techniques than microcatheters.
The mean age of the patients was 80.1 years, 7 (58%) were female, 6 (50%) were on dialysis, 3 (25%) had intermittent claudication, 9 (75%) had CLTI, and half were unable to walk. The lesion site was the iliac artery in 1 case (7%), the femoral popliteal artery in 5 cases (42%), the popliteal artery in 6 cases (50%), CTO in 9 cases (75%), and severe calcification of PACSS grade ≥3 was identified in all cases.
The needle rendezvous technique puncture site was the common femoral artery in 1 case (7%), the SFA in 4 cases (33%), and the below-knee artery in 7 cases (58%); 11 cases (92%) showed bilateral calcification at the puncture site.
The technical success rate set as the primary endpoint was 100%, with no complications related to the puncture site or procedure. The time from puncture to guidewire removal from the body was as short as 5.3 minutes, and the total procedure time was 145.5 minutes.
Dr. Tsujimoto summarized, "Although the guidewire passes through the lesion and cannot be applied to arteries above the inguinal region, and puncture skills are required, the needle rendezvous technique was shown to be safe and useful for externalization of the guidewire when delivery of the device from the antegrade is difficult using conventional techniques."
※コンテンツには、国内で未承認、適応外の医療機器、医薬品、または効能・効果/用法・用量の情報を含む場合がありますが、未承認、適応外の使用を推奨するものではありません。
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