Retrospective Analysis of Peripheral Vascular Intervention Procedural and Safety Outcomes With Utilization of the Glidesheath Slender for Tibiopedal Access

On Friday, George Pliagas, MD, FACS, FRCSC, from ACV Vascular in Las Vegas, Nevada, presented information about the Glidesheath Slender (Terumo) for tipiopedal access. He began by providing key points about peripheral arterial disease (PAD) and critical limb ischemia (CLI): 

Prevalence and impact of PAD and CLI:

• PAD and CLI are increasingly common, particularly in an aging population.
• CLI has a high mortality rate of 70% at 10 years.
• Retrograde tibiopedal access has emerged as a significant advancement, improving treatment success and patient outcomes.

Historical context:

• Chronic lower extremity ischemia has long been a serious health issue with poor outcomes for conservative treatment.
• The Seldinger technique, introduced in 1952, revolutionized vascular access and angiography.

Challenges with access techniques:

• The choice of access site for intervention involves multiple factors and can impact procedural success.
• Traditional sheathless techniques can lead to complications such as endothelial trauma and thrombosis.

Dr. Pilagas then described the Glidesheath Slender and reviewed its benefits, including the fact that a study of 445 patients demonstrated that the Glidesheath Slender facilitated successful tibiopedal access in all cases and the thin-walled design of the sheath reduces complications and allows for more flexible treatment options. The study covered interventions from September 2018 to September 2020, focusing on procedural outcomes and safety. The average procedure time was 103 minutes, with a 100% success rate for access and a low complication rate of 13.2%. Common complications included access site occlusion and bleeding, all managed conservatively. 

He also presented a case study that highlighted the efficacy of tibiopedal access in treating complex iliac disease that had previously required open surgery.

In conclusion, Dr. Pliagas said that the Glidesheath Slender has proven to be an effective tool for peripheral vascular interventions, offering high success rates and low complication rates. This approach expands treatment options for complex cases and provides a safer alternative to traditional methods.