ORIGINAL ARTICLE
Year : 2021  |  Volume : 8  |  Issue : 4  |  Page : 351-354

The mathematical basis of multi-sheath vascular access


1 Department of Vascular Surgery, Nepean Hospital, Penrith, NSW; Department of Surgery, Nepean Clinical School, University of Sydney, Sydney, Australia
2 Department of Vascular Surgery, Nepean Hospital, Penrith, NSW, Australia

Correspondence Address:
Arvind Lee
Department of Vascular Surgery, Nepean Hospital, Penrith, NSW; Department of Surgery, Nepean Clinical School, University of Sydney, Sydney
Australia
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Source of Support: None, Conflict of Interest: None


DOI: 10.4103/ijves.ijves_69_21

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In complex endovascular interventions, there is often a need for multiple smaller sheaths to be placed parallelly inside a larger sheath to gain simultaneous access into different vessels. Here, we describe one such case of fenestrated repair of a juxtarenal aneurysm from our recent experience. This case required simultaneous cannulation with sheaths in both renal arteries and the superior mesenteric artery through the fenestration of a custom-made fenestrated stent graft. This paper aims to discuss, in simple terms, the mathematical basis behind calculating the diameters of smaller sheaths inside a larger sheath. Three different configurations are discussed – two, three, and four sheaths within a larger sheath. For simplicity, the inside sheaths are all of the same outer diameter and the diameter of all the sheaths is assumed to remain uniform throughout their lengths.


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