Popis: |
Summary The iliac artery is possibly the most amenable for endovascular therapy. Stenosis is the easiest lesion for treatment and training in endovascular surgery, due to its high incidence in ischaemic patients, as well as the good results obtained. Besides the expertise, a well-equipped operating room and an appropriate material are of paramount importance. In relation to the equipped operating room, all endovascular theatre should be provided with a radiotransparent table and digital C-arm arch (digital subtraction, road mapping and video). Radioprotection must be followed strictly according to the national regulation requirements, in Spain, the Nuclear Security Council. The necessary material must be available, therefore sheaths, guidewire (regular, hydrophilic and stiff), catheters (Simons, Hockey Stick, Pig Tail and Cobra), balloons and stents (self-expanding, balloon expanded and covered one) should be reach in short time from requested. It is important to have experience in percutaneous arterial catheterization, as well as the capability to gain access to the lesion through femoral contralateral or axilar arm approaches. Initially, most cases will be dealt with a single angioplasty, in some cases a stent must be deployed. We should be capable of treating complex lesions, such a recanalization of chronic occlusive disease. Lesions in the aortic bifurcation may need of the kissing balloon technique. Aortic endograft is the final step in endovascular training, for which a thorough knowledge of the different devices and related techniques, such as arterial embolization (lumbar, internal iliac), is mandatory. |