Additional Supporting Information may be found in the online version of this article.

ccd24380-sup-0001-SuppFig1.tif2305KSupporting Fig. 1. An illustration of the ‘modified crossover technique’ for vascular access management. Panel A demonstrates the position of the 0.018″ guidewire advanced from the left radial artery to the distal therapeutic femoral artery. An angiographic image is made injecting contrast through a multi-purpose catheter to identify the therapeutic access site anatomy. In Panel B following valve delivery, the large bore sheath is retracted and an over-the-wire balloon is positioned via the left radial artery to the common iliac of the therapeutic site. This can then be inflated at low pressure (Panel C) to allow sheath removal and full Prostar closure in a bloodless field. Panel D shows the final angiographic image of the closure site by injecting contrast through the central lumen of the over-the-wire balloon, to ensure no vascular complications.

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