Figure 25

A small arteriotomy is made with a #11 blade (upper panel) to allow an #18 – 22 Fr angiocatheter flushing the artery while the vascular clips are sequentially opened (middle panel). Alternatively a smooth ‘christmas-tree’ is used. With either technique the artery in spasm is gently dilated under hydro-pressure (Figure X). The arteriotomy, about 45 degrees on the radial side or lateral is approximatley extended to match the venous path, usually 8-10 mm (bottom panel).