Percutaneous femoral access: Stuck guide wire, decannulation difficulty due to unravelling and knotting
10.7461/jcen.2024.E2023.06.002
- Author:
Bhanu Pratap Singh CHAUHAN
1
;
Binita DHOLAKIA
;
Ashfaque KHAN
;
Chirag HIRANI
;
Satheesh KUMAR
;
Dibya Jyoti MAHAKUL
;
Abhishek KATYAL
;
Wajid NAZIR
;
Daljit SINGH
Author Information
1. Department of Neurosurgery, GB Pant Institute of Post Graduate Medical Education and Research, New Delhi, India
- Publication Type:Technical Note
- From:Journal of Cerebrovascular and Endovascular Neurosurgery
2024;26(2):223-226
- CountryRepublic of Korea
- Language:English
-
Abstract:
Percutaneous techniques for femoral arterial access are increasingly being performed due to advances in endovascular cerebral procedures, as they provide a less morbid and minimally invasive approach than open procedures. Common complications associated with this peripheral puncture include hematoma, bleeding, pseudoaneurysm, arteriovenous fistula, retroperitoneal bleeding, inadvertent venous puncture, dissection, etc. The retrograde femoral access is currently the most frequently used arterial access as it is technically straightforward, allows for the use of larger size sheaths and catheters, allows repeated attempts, etc. Although being technically less challenging, grave complications can occur due to hardware failure. Here, we present a case of unruptured posterior inferior cerebellar artery (PICA) aneurysm, who underwent uneventful diagnostic cerebral digital substraction angiography (DSA) via right femoral artery route on first attempt, but on second attempt for therapeutic intervention, landed up with stuck guide wire and faced decannulation difficulty due to unravelling of guide wire and multiple knot formation, which was finally removed after multiple attempts at pulling and improvised manoeuvres. Such cannulation and decannulation difficulties have been reported multiple times for central venous access, but extremely rarely for femoral routes, making this case a rarity and worth reporting.
