Simple Standard Technique for Catheterization of the Short Stub Leg of Modular Aortic Endografts and Confirmation of Coaxial Guidewire Positioning

AbstractObjectiveTo describe our experience of a technique for cannulation of the short limb of modular devices and confirmation of coaxial positioning, in endovascular treatment of abdominal aortic aneurysms.MethodsIn 60 consecutive patients with abdominal aortic aneurysms treated with modular endografts, a standard short leg cannulation system was employed. This system includes insertion of a long sheath through the contralateral common femoral artery over a previously inserted guidewire. After the deployment of the main bifurcated body of the device, a second flexible guidewire via the same long sheath is used for catheterization of the short stub leg. The successful cannulation is confirmed by performing the simple test of advancing the sheath over the two guidewires.ResultsThe short stub leg catheterization was successful in all cases, followed by proper placement of the contralateral iliac limb.ConclusionThe ‘two wires via the same long sheath system’ is a simple and reliable technical step for the accurate placement of the contralateral iliac limb as part of the endovascular repair of abdominal aortic aneurysm procedure