In this case, exposure of the left groin was preferred over puncture because of severe scarring in the groin after previous surgery and the large caliber of the delivery system. After encircling the common femoral artery centrad and distad, puncture the artery in Seldinger technique. Introduce a 7 F sheath over the guidewire. Administer 5000 IU heparin saline locally into the vessel.
Tip:
To avoid vessel perforation, do not advance the stiff guidewire too far because of the severe kinking of the left iliac arteries and the paper-thin vessel walls.