What is a Waltman loop?
The distal tip of any catheter can be looped back to form a reverse curve catheter.
A Waltman loop is the configuration of a standard catheter when the distal end has been formed into a reverse curve loop.
The simplest technique to do this involves selection of an aortic branch vessel.
The tip is maintained in a constant position as wire and catheter are advanced in unison.
This creates a large reverse curve that can stabilize access and facilitate difficult catheterizations.
The usual ipsilateral approach for uterine artery embolization is to form a Waltman loop.
Newer nonbraided 4-F catheters can be problematic because of their tendency to kink or unfold while the loop is being formed.
Herein, a modification of the Cope suture technique is described by which a Waltman loop is formed with use of a 4-0 Tevdek suture that allows the catheter to be folded back on itself, drawing it into the ipsilateral iliac artery.
If necessary, the catheter can be prevented from unlooping by twisting the catheter on itself to lock it in position.
The technique allows for efficient catheterization of the ipsilateral uterine artery.
