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Jincheng Guo, Wenming Chen, Guozhong Wang, Zijing Liu, Minghui Hao, Min Xu, Fuli Zhu
BACKGROUND: There are limited data on the impact of using a single dedicated radial guiding catheter in primary percutaneous coronary intervention (PCI) via radial access. OBJECTIVES: To investigate the effect of using a single guiding catheter (MAC 3.5) for left and right coronary angiography and intervention on catheterization laboratory door to balloon (C2B) time in patients with ST elevation myocardial infarction (STEMI). METHODS: Three hundred and sixty patients were randomized (1:1) to using a single MAC3...
October 25, 2016: Journal of Interventional Cardiology
Konstantinos V Voudris, Martha Habibi, Panagiotis Karyofillis, Mladen I Vidovich
The volume of cardiac diagnostic procedures involving the use of ionizing radiation has increased rapidly in recent years, and the radiation exposure experienced by patients undergoing any medical imaging procedure has recently obtained a growing attention. Transradial (TR) access is being increasingly used worldwide for diagnostic coronary angiography (CA), and percutaneous coronary interventions, since it offers several benefits as compared to transfemoral (TF) access, such as by reducing hemostasis time and vascular complications, increased patient comfort, reduced hospital stay, and lower cost...
December 2016: Current Treatment Options in Cardiovascular Medicine
Vivian L Bishay, Derek M Biederman, Thomas J Ward, Imramsjah Martijn J van der Bom, Rahul S Patel, Edward Kim, Francis S Nowakowski, Robert A Lookstein, Aaron M Fischman
OBJECTIVE: The transradial approach (TRA) has been shown to reduce the morbidity and mortality associated with arterial coronary interventions. Selective internal radiation therapy (SIRT) performed via the TRA can enhance patient comfort, compared with the traditional transfemoral approach (TFA), by allowing immediate ambulation and precluding potential complications associated with the TFA, such as closure device injury or retroperitoneal hematoma. We report our initial experience with and technique for using the TRA for SIRT...
November 2016: AJR. American Journal of Roentgenology
A J Mitchell, N L Mills, D E Newby, N L M Cruden
AIMS: To determine the reproducibility of flow-mediated dilation (FMD) and nitrate-mediated dilation (NMD) in the assessment of radial artery vasomotor function, and to examine the effect of transradial catheterisation on radial artery injury and recovery. METHODS: Radial artery FMD and NMD were examined in 20 volunteers and 20 patients on four occasions (two visits at least 24 hours apart, with two assessments at each visit). In a further 10 patients, radial artery FMD was assessed in the catheterised arm prior to, at 24 hours and 3 months following cardiac catheterisation...
2016: Open Heart
Anil Potdar, Ganeshrao Sapkal, Satyavan Sharma
Situs inversus dextrocardia is a challenging situation for an interventional cardiologist. This report presents a rare case where multivessel percutaneous coronary intervention was performed in a single sitting using transradial approach. The challenges encountered in the procedure and clues to successful outcome are discussed.
September 2016: Indian Heart Journal
Bogdan Januś, Ireneusz Nawrot, Maciej Zarębiński, Sławomir Nazarewski, Olgierd Rowiński
No abstract text is available yet for this article.
2016: Kardiologia Polska
Samir B Pancholy, Gaurav Patel, Sukrut P Nanavaty, Maitri S Pancholy
Cardiogenic shock (CS) following ST-elevation myocardial infarction (STEMI) is a devastating complication and continues to have a high mortality rate. Coronary revascularization with percutaneous coronary intervention (PCI) is the cornerstone in the management of CS; however, PCI-related access-site bleeding has been observed to be more prevalent in CS patients. Historically, PCI by transfemoral access (TFA) has been the preferred approach over transradial access (TRA) in CS patients due to weak radial pulse, operators' inexperience with TRA, and the use of TFA for concomitant mechanical cardiovascular support...
October 11, 2016: Minerva Cardioangiologica
Maurits R Hollander, Maarten A H van Leeuwen, Dirk van der Heijden, Vincent M N Keizer, Peter M van de Ven, Sander J J IJsselmuiden, Nicolas M Van Mieghem, Giovanni Amoroso, Marco J P F Ritt, Paul Knaapen, Niels van Royen
AIMS: During transradial coronary catheterization the radial artery is functionally occluded and hand perfusion depends on the collateral circulation. Nexfin is a simple, non-invasive technique to measure digital arterial pressure and could serve to quantify the palmar collateral circulation. Potentially, inter-individual differences in the extent of collateralization are related to perfusion and function after transradial intervention. METHODS AND RESULTS: In total 85 adults were included (18 healthy volunteers; 67 patients who underwent transradial catheterization)...
October 11, 2016: EuroIntervention
George Hahalis, Spyridon Deftereos, Olivier F Bertrand
Despite the increasing worldwide adoption of the transradial access site, the ulnar artery (UA) only very infrequently serves as a primary option for coronary procedures. In contrast to the uncertainty surrounding previous reports regarding the feasibility and safety, recent data from larger registries and randomized trials provide more conclusive evidence that the transulnar route may be safely selected as an alternative arterial access approach. However, a default transulnar strategy appears time-consuming and is associated with higher crossover rates compared with the radial artery (RA)...
August 20, 2016: Hellenic Journal of Cardiology: HJC, Hellēnikē Kardiologikē Epitheōrēsē
Samir B Pancholy, Ivo Bernat, Olivier F Bertrand, Tejas M Patel
OBJECTIVES: The study sought to evaluate whether prophylactic ipsilateral ulnar artery compression during radial artery hemostasis could reduce the risk of radial artery occlusion (RAO). BACKGROUND: RAO after transradial access (TRA) is a structural complication of TRA. It limits future ipsilateral TRA and may cause transient pain. Maintaining radial artery flow during hemostasis reduces the incidence of acute RAO. Ipsilateral ulnar compression increases radial artery flow and could impact the incidence of RAO...
October 10, 2016: JACC. Cardiovascular Interventions
Mamas A Mamas, Sudhakar George, Karim Ratib, Chun Shing Kwok, Abdelnasir Elkhazin, Kully Sandhu, Julie Stubbs, Pamela Luxford, James Nolan
BACKGROUND: While the uptake of transradial access site is growing, there are concerns about associated radial injury. We report a feasibility study of a technique that enables both 5Fr diagnostic and PCI cases to be undertaken without an arterial sheath using conventional diagnostic and guide catheters with a modified balloon assisted tracking (BAT) technique. METHODS: We performed a prospective single center pilot study to assess the feasibility and effectiveness of sheathless radial artery access and BAT to perform coronary angiography and angioplasty using conventional 5 Fr diagnostic and guide catheters...
September 18, 2016: Cardiovascular Revascularization Medicine: Including Molecular Interventions
J Han Deuling, Robert P Vermeulen, Ad Fm van den Heuvel, Remco Aj Schurer, Pim van der Harst
BACKGROUND: Radial access is the preferential access route in patients undergoing diagnostic coronary angiography. We hypothesised that we could reduce hospital stay and improve patient comfort by accelerated deflation of the radial compression device (Terumo radial band). AIMS: The aim of this study was to compare accelerated pressure reduction with a standard Terumo radial band protocol with regard to local bleeding complications and reported pain scores after cardiac catheterisation...
October 3, 2016: European Journal of Cardiovascular Nursing
Heyang Wang, Yi Li, Hongliang Cong, Shifang Ding, Bin Liu, Lu Li, Yundai Chen, Shaobin Jia, Quanmin Jing, Xin Zhao, Haiwei Liu, Zhenyang Liang, Jing Li, Dan Bao, Yaling Han
OBJECTIVES: To explore the efficiency and safety of bivalirudin in patients undergoing emergency percutaneous coronary intervention via radial access. BACKGROUND: Bivalirudin reduces bleeding risks over heparin in patients undergoing PCI. However, bleeding advantages of bivalirudin in patients undergoing transradial intervention is uncertain. METHODS: In the BRIGHT trial, 1,723 patients underwent emergency PCI via radial access, with 576 patients in the bivalirudin arm, 576 in the heparin arm and 571 in the heparin plus tirofiban arm...
September 28, 2016: Catheterization and Cardiovascular Interventions
Yasuhiro Nakano, Kenji Sadamatsu
Minimizing the catheter size can reduce vascular access complications and contrast dye usage in coronary angiography. The small diameter of the 4Fr guiding catheter has limited the use of several angioplasty devices such as intravascular ultrasound (IVUS) in the past. However, the combination of a novel IVUS catheter and a 0.010 guidewire makes it possible to perform IVUS-guided percutaneous coronary intervention (PCI) with a 4Fr guiding catheter. We herein report the case of a 51-year-old man with silent myocardial ischemia who underwent IVUS-guided transradial PCI with a 4Fr guiding catheter...
2016: Case Reports in Cardiology
Mohammed Ruzieh, Ankush Moza, Bhavana Siddegowda Bangalore, Thomas Schwann, Jodi Lee Tinkel
BACKGROUND: Transradial catheterisation is known to be associated with occlusion of the radial artery with an estimated incidence of 2-10% (1). There are very few studies looking at the patency of radial artery as a bypass graft after utilisation for catheterisation. METHODS: We conducted a retrospective review of patients undergoing coronary artery bypass grafting (CABG) utilising a radial artery graft. RESULTS: Long term patency rates were 59% in radial artery grafts utilised for catheterisation prior to CABG, compared to 78% if it were not (p= 0...
August 26, 2016: Heart, Lung & Circulation
Manish Patwardhan, Sanjay Mehra, Assad Movahed, Ramesh Daggubati
The percutaneous transradial approach for coronary angiography and percutaneous coronary intervention is increasing in the United States. Although its vascular safety profile is better than the traditional femoral approach, it is important to learn about potential complications. In this article, we present two cases of vascular complications, namely, pseudoaneurysm and radial artery occlusion, after transradial cardiac catheterization, along with a review of the relevant literature.
2016: Reviews in Cardiovascular Medicine
Rami M Abazid, Osama A Smettei, Mohamed Z Mohamed, M Obadah Kattea, Annie Suresh, Yasir Beshir, Haitham Sakr
BACKGROUND: The transradial approach has become the preferred vascular access during conventional coronary angiography (CCA). Hereby, we evaluated the impact of pre-procedural radial artery diameter (RAD), the cross-sectional area (CSA), and the perimeter on vascular complications (VACs). METHODS: We conducted a single-center prospective analysis of 513 patients who underwent CCA. Radial artery ultrasonography was performed before and after CCA to measure the RAD, CSA, and perimeter...
September 26, 2016: Cardiology Journal
Orhan Maden, Habibe Kafes, Kevser Gülcihan Balci, Muharrem Tola, Mehmet Timur Selçuk, Cengiz Burak, Elif Hande Çetin, Hatice Selçuk, Mustafa Mücahit Balci, Halil Lütfü Kısacık
Although heparin administration has reduced the incidence of radial artery occlusion (RAO) during the transradial coronary angiography (TRCA), the effective activated clotting time (ACT) value for guiding unfractionated heparin dosing in patients undergoing TRCA is unknown. Four hundred thirty-two patients who were scheduled for elective TRCA were enrolled in our prospective study. All the patients received a standard dose of 5,000 IU unfractionated heparin. Anticoagulation level was assessed by ACT measurements that were taken at the end of the procedure just before the sheath removal...
August 23, 2016: American Journal of Cardiology
Tereza Novakova, Jan Kanovsky, Roman Miklik, Otakar Bocek, Martin Poloczek, Petr Jerabek, Lenka Privarova, Tomas Ondrus, Jiri Jarkovsky, Klara Benesova, Jindrich Spinar, Petr Kala
BACKGROUND AND AIMS: Transradial catheterization is the predominant access site for coronary catheterization and percutaneous coronary interventions (PCI). Previous studies have reported a high incidence of radial artery (RA) injury. The aim of this investigation was to evaluate the incidence of RA injury using last generation optical coherence tomography (OCT) intravascular imaging in a serial manner. METHODS: 100 patients with a diagnosis of non-ST-elevation myocardial infarction (nSTEMI) treated by PCI were enrolled...
September 2016: Biomedical Papers of the Medical Faculty of the University Palacký, Olomouc, Czechoslovakia
Elizabeth Curtis, Ritin Fernandez, Astin Lee
The quantitative objective is to identify the effectiveness of vasodilatory medications on radial artery spasm in patients undergoing transradial coronary artery procedures.
August 2016: JBI Database of Systematic Reviews and Implementation Reports
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