Chapter 6: Basic Endovascular Skills

The following sections are included:

• Endovascular practice involves three key elements:

  • Safe Access: How to get into a blood vessel safely. Ultrasound-guided Seldinger technique allows a safe approach to the arterial system. The common femoral is the most frequently used access site, but alternative access approaches like the brachial, popliteal, radial and tibiopedal also have benefits.

  • Safe Navigation: An understanding of the tools which can be used inside blood vessels. Guidewires have a central core and outer covering which determine their behaviour. Catheters are sized in French (Fr) which refers to their outer diameter. They come in a range of lengths and sizes and allow injection of contrast and a way to steer and support the guidewire.

  • Safe Closure: How to safely close the vessel at the end of a procedure. Manual compression of a vessel is a safe way to close a vessel but closure devices can produce quicker haemostasis and earlier ambulation. Vascular access up to 24Fr can also be closed percutaneously with pre-deployed suture mediated devices.