Snare-assisted vascular access: A new technique

Access to the central circulation can be difficult in small infants, partic ularly when normal anatomic landmarks have been altered. We describe a new technique that utilizes any existing central catheter to establish addition al sites of vascular access. A 4 Fr end hole catheter is advanced under flu oroscopic guidance to-the desired site of new vascular access. A 10-mm Ampl atz snare catheter is advanced through the end hole catheter and the loop o pened within the target vessel lumen. The snare is then used to guide percu taneous placement of a Cope wire through a 21-gauge needle and then to pull the wire into the central circulation. New access is then achieved by intr oducing an additional catheter over the guidewire, This technique has now b een successfully utilized 16 times in 13 patients. Snare assistance is a sa fe and effective technique that provides a reliable means of establishing a dditional secure vascular access. Cathet. Cardiovasc. Intervent. 47:315-318 , 1999. (C) 1999 Wiley-Liss, Inc.