TEVAR / EVAR: the way to go in most patients with thoracic or abdominal aorta aneurysm. Are there things to take care of? Here are some of them:
- Never use a hydrophilic wire as a guide wire. It poses a serious danger of dissection. Use it only in difficult points, just to get out of the difficult situation, and then exchange it for a standard J-tip wire.
- In case of possible dissection of iliac artery do not hesitate to go for a cross-over from the other femoral artery.
- If you need to catheterise a splanchnic artery, localize its position in relation to the close vertebrae, on the preop CT. Then identify this area on the C-arm view and try to catheterize the vessel using just an SOS Omni catheter with a syringe with contrast on its end and not a wire. After catheterizating the vessel, live the catheter there; do not use a hydrophilic catheter: there is danger of throwing back the catheter when one tries to advance the wire into the splanchnic vessel (especially on the celiac axis, or the SMA)
- Always double-check the SFA artery when closing the femoral arteriotomy. You may need to use a Fogarty catheter.
- Have always around:
- Snare
- Hydrophilic wire with J-tip
- SOS Omni catheter
