Crossover approach with a J-shaped sheath for angioplasty of iliofemoral artery stenoses and occlusions.

Thirty patients with atherosclerotic stenoses or occlusions of iliofemoral arteries were treated from the contralateral approach using a newly designed J-shaped sheath. Seven patients with stenoses and one with an occlusion were successfully dilated with balloon angioplasty. Twenty-two patients with occlusions were treated with urokinase infusion, 16 of whom received coaxial infusion with the J-shaped sheath and catheter. Complete thrombolysis was achieved in 18 patients. The treatment success rate was 100% in the stenotic group and 83% in the occlusion group. Initially, J-shaped sheaths were useful for treatment of iliofemoral artery lesions from the contralateral femoral artery.