Abstract

The most prevalent symptom of lower limb artery occlusions is intermittent claudication. The most commonly used technique to treat symptomatic patients is balloon dilatation of the occlusive plaque. Balloon dilatation of the lesion may cause dissection. The dissected artery wiring is a challenging scene. First, we can implant a stent in the dissection and then use it to cross the sealed artery. Additionally, we can use dual lumen catheters or dual lumen balloon catheters. But sometimes, angiography labs do not have these modern devices. In the present case, we came up with a solution and successfully finished the procedure by using a balloon catheter to transfer the second guidewire, which cannot pass through the dissected lesion. We named the technique Peripheral Artery Sidecar Technique (PAST).

Keywords: Angioplasty, dissection, guidewire, peripheral artery

Copyright and license

Copyright © 1970 The Author(s). This is an open-access article published by Bolu İzzet Baysal Training and Research Hospital under the terms of the Creative Commons Attribution License (CC BY) which permits unrestricted use, distribution, and reproduction in any medium or format, provided the original work is properly cited.

How to cite

1.
Acar E, Dönmez İ, İzci S, Kaygusuz T, Özcan E, İzgi İA, et al. PAST, a novel solution for crossing another wire in the severely dissected peripheral artery. Northwestern Med J. 2025;5(3):194-9. https://doi.org/10.54307/2025.NWMJ.93

References

  1. Armstrong EJ, Brodmann M, Deaton DH, et al. Dissections after infrainguinal percutaneous transluminal angioplasty: a systematic review and current state of clinical evidence. J Endovasc Ther. 2019; 26(4): 479-89. https://doi.org/10.1177/1526602819855396
  2. Fujihara M, Takahara M, Sasaki S, et al. Angiographic dissection patterns and patency outcomes after balloon angioplasty for superficial femoral artery disease. J Endovasc Ther. 2017; 24(3): 367-75. https://doi.org/10.1177/1526602817698634
  3. Voûte MT, Stathis A, Schneider PA, et al. Delphi consensus study toward a comprehensive classification system for angioplasty-induced femoropopliteal dissection: the DISFORM study. JACC Cardiovasc Interv. 2021; 14(21): 2391-401. https://doi.org/10.1016/j.jcin.2021.07.056
  4. Banerjee S, Sarode K, Mohammad A, et al. Femoropopliteal artery stent thrombosis: report from the excellence in peripheral artery disease registry. Circ Cardiovasc Interv. 2016; 9(2): e002730. https://doi.org/10.1161/CIRCINTERVENTIONS.115.002730
  5. Pyxaras SA, Galassi AR, Werner GS, et al. Dual lumen microcatheters for recanalisation of chronic total occlusions: a EuroCTO Club expert panel report. EuroIntervention. 2021; 17(12): e966-70. https://doi.org/10.4244/EIJ-D-21-00291
  6. Leibundgut G, Büttner HJ. A simple solution to deliver a second guidewire without a dual-lumen microcatheter-The sidecar technique. Clin Case Rep. 2021; 9(9): e04787. https://doi.org/10.1002/ccr3.4787