Management of the Percutaneous Access Site

  • James W. Vetter


In the first edition of this textbook, I discussed overall management of the percutaneous access site. Since that chapter was written, a great deal has changed in endovascular procedures. Rather than restate aspects that have remained the same (e.g., the importance of care and precision when accomplishing a correctly placed sheath), it is more useful to provide an update on the advances in devices, techniques, and strategies that have been developed. It is also useful to resummarize some of the most important principles and techniques that remain unchanged. Because most of the advances involve the Perclose procedure and the ways in which it can be used to permit new diagnostic and interventional strategies, more space is devoted to these devices. There is an obvious bias toward the Perclose devices because their use allows the widest choice of interventional strategies, and they offer the most secure method of access site management. The use of Perclose devices is growing rapidly worldwide, so there is also a section in this chapter dedicated to the practical use of the devices. In particular, the discussion is directed toward new strategies for endovascular procedures.


Access Site Superficial Femoral Artery Chronic Total Occlusion Collagen Device Endovascular Procedure 
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© Springer Science+Business Media New York 1999

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  • James W. Vetter

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