Fig 3.
Technique for management of the access vessel in fragile vasculature of Ehlers-Danlos syndrome (EDS) patient. (A) A “U” stitch monofilament suture is placed with a pledget buttress, and needle entry is made within the area. (B) Sheath access is obtained and manipulated or exchanged minimally to avoid femoral tears. (C) The pledgetted “U” stitch suture is tied down as sheath is removed. (D) Circumferential felt reinforcement is approximated to reduce systolic pulse wave stretch on sutures and to prevent late pseudoaneurysm formation.