Iliac Artery Dissection and Perforation During Crossover Sheath Insertion

  • Robert S. Dieter
  • Jeffrey Freihage
  • John P. PacanowskiJr.
  • Walter Coats
  • Aravinda Nanjundappa


Fundamentally, vascular access is arguably one of the most important steps in any interventional procedure. Determination of initial access site is based upon several factors, including the territory being treated, the complexity of the stenosis, anticipated complications, and distance to the target lesion. Oftentimes, arterial access for interventional procedures involving iliofemoral targets is via the contralateral common femoral artery. Access to the lesion is then via a crossover technique. This approach avoids many of the potential pitfalls of antegrade punctures or even upper extremity access. However, invariably it involves multiple catheter and wire exchanges to ultimately position a sheath over the aortic bifurcation into the target side that needs to be treated.


Iliac Artery Target Lesion Vascular Access Interventional Procedure Artery Dissection 
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Copyright information

© Springer Science+Business Media New York 2014

Authors and Affiliations

  • Robert S. Dieter
    • 1
    • 2
  • Jeffrey Freihage
    • 3
  • John P. PacanowskiJr.
    • 4
  • Walter Coats
    • 5
  • Aravinda Nanjundappa
    • 6
  1. 1.Interventional CardiologyLoyola University Medical CenterMaywoodUSA
  2. 2.Vascular Medicine and Cardiovascular Interventions, Cardiovascular CollaborativeHines VA HospitalHinesUSA
  3. 3.Interventional CardiologistChicago Cardiology InstituteSchaumburgUSA
  4. 4.Vascular and Endovascular SurgeryTucson Medical CenterTusconUSA
  5. 5.Department of Interventional CardiologyLoyola UniversityMaywoodUSA
  6. 6.Department of MedicineWest Virginia UniversityCharlestonUSA

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