A high flow arteriovenous shunts in newborns may require urgent endovascular treatment right immediately after delivery if high output cardiac failure is resistant to medical treatment. The umbilical approach is often the first choice of the access route for endovascular treatment in the newborn. It is, however, not infrequent that the patient has an extensive lesion, which necessitates a second session of treatment because of the limitation of the usable amount of the contrast material in one session. In such a case, re-puncturing the femoral artery is difficult and carries the risk of leg ischemia. On the other hand, leaving the umbilical sheath for the second procedure carries risks of infection, thrombosis, and vessel injury. Herein we introduce our umbilical vessel catheter (UVC) retro-exchange technique (U-RET) in which we replace the umbilical sheath to a 3.5Fr UVC at the end of the first endovascular procedure to preserve the umbilical artery access and prepare for the repeated use. We believe that this method minimizes the risks of infection and vessel injury.

如果高输出量心力衰竭对药物治疗有抵抗力，新生儿的高流量动静脉分流可能需要在分娩后立即进行紧急血管内治疗。脐入路通常是新生儿血管内治疗的首选入路。然而，患者病变范围广泛的情况并不少见，由于一次治疗中造影剂的可用量的限制，需要进行第二次治疗。在这种情况下，重新穿刺股动脉很困难，并且存在腿部缺血的风险。另一方面，保留脐鞘进行第二次手术会带来感染、血栓形成和血管损伤的风险。在此，我们介绍我们的脐血管导管 (UVC) 逆向交换技术 (U-RET)，其中我们在第一次血管内手术结束时将脐血管鞘替换为 3.5Fr UVC，以保留脐动脉通路并为重复的手术做好准备使用。我们相信这种方法可以最大限度地减少感染和血管损伤的风险。