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Elias B Hanna, Owen N Mogabgab, Hassan Baydoun
We present cases of complex, calcified iliac occlusive disease revascularized via a combined radial-femoral access strategy. Through a 6-French, 125-cm transradial guiding catheter, antegrade guidewires and catheters are advanced into the iliac occlusion, while retrograde devices are advanced transfemorally. The transradial and transfemoral channels communicate, allowing the devices to cross the occlusion into the true lumen (radial-femoral antegrade-retrograde rendezvous).
January 1, 2018: Vascular and Endovascular Surgery
Concetta Irace, Salvatore De Rosa, Cesare Tripolino, Giuseppe Ambrosio, Caterina Covello, Ennio Abramo, Claudio Carallo, Annalisa Mongiardo, Carmen Spaccarotella, Daniele Torella, Agostino Gnasso, Ciro Indolfi
Endothelial dysfunction, wall thickening and plaque are progressive manifestations of atherosclerosis. Delayed or absent brachial artery dilation after ischemic stimulus has been associated with severity of extracoronary and coronary atherosclerosis. In the current study, we aimed to verify if delayed or absent dilation associates with critical coronary stenosis. We also evaluated the association between coronary stenosis, carotid artery wall thickness and peripheral artery disease. Endothelial function was investigated by flow-mediated dilation of the brachial artery up to 3 min after ischemia, and patients classified as early, late or no dilators...
March 17, 2018: Journal of Investigative Medicine: the Official Publication of the American Federation for Clinical Research
Giuseppe Gargiulo, Greta Carrara, Enrico Frigoli, Pascal Vranckx, Sergio Leonardi, Nestor Ciociano, Gianluca Campo, Ferdinando Varbella, Paolo Calabrò, Stefano Garducci, Alessandro Iannone, Carlo Briguori, Giuseppe Andò, Gabriele Crimi, Ugo Limbruno, Roberto Garbo, Paolo Sganzerla, Filippo Russo, Alessandro Lupi, Bernardo Cortese, Arturo Ausiello, Salvatore Ierna, Giovanni Esposito, Dennis Zavalloni, Andrea Santarelli, Gennaro Sardella, Simone Tresoldi, Nicoletta de Cesare, Alessandro Sciahbasi, Antonio Zingarelli, Paolo Tosi, Arnoud van 't Hof, Elmir Omerovic, Salvatore Brugaletta, Stephan Windecker, Marco Valgimigli
BACKGROUND: Contrasting evidence exists on the comparative efficacy and safety of bivalirudin and unfractionated heparin (UFH) in relation to the planned use of glycoprotein IIb/IIIa inhibitors (GPIs). OBJECTIVES: This study assessed the efficacy and safety of bivalirudin compared with UFH with or without GPIs in patients with acute coronary syndrome (ACS) who underwent invasive management. METHODS: In the MATRIX (Minimizing Adverse Haemorrhagic Events by Transradial Access Site and Systemic Implementation of AngioX) program, 7,213 patients were randomly assigned to receive either bivalirudin or UFH with or without GPIs at discretion of the operator...
March 20, 2018: Journal of the American College of Cardiology
Linda Resnik, He Helen Huang, Anna Winslow, Dustin L Crouch, Fan Zhang, Nancy Wolk
BACKGROUND: Although electromyogram (EMG) pattern recognition (PR) for multifunctional upper limb prosthesis control has been reported for decades, the clinical benefits have rarely been examined. The study purposes were to: 1) compare self-report and performance outcomes of a transradial amputee immediately after training and one week after training of direct myoelectric control and EMG pattern recognition (PR) for a two-degree-of-freedom (DOF) prosthesis, and 2) examine the change in outcomes one week after pattern recognition training and the rate of skill acquisition in two subjects with transradial amputations...
March 15, 2018: Journal of Neuroengineering and Rehabilitation
Orazio Valsecchi, Angelina Vassileva, Alberto Francesco Cereda, Paolo Canova, Keisuke Satogami, Luigi Fiocca, Giulio Guagliumi
BACKGROUND: Distal transradial access in the anatomical snuffbox has advantages over standard access in terms of patient and operator comfort levels and risk of ischemia. Radial artery preservation could be a relevant issue in patients requiring multiple radial artery procedures and coronary bypass with the use of a radial graft. One relevant drawback is the challenging puncture of a small and weak artery, with a steeper learning curve. AIM: The study was aimed at proving feasibility and safety of right and left transradial access in the anatomical snuffbox...
March 15, 2018: Journal of Invasive Cardiology
Mohammad A Hossain, Amy Quinlan, Jennifer Heck-Kanellidis, Dawn Calderon, Tejas Patel, Bhavika Gandhi, Shrinil Patel, Mahida Hetavi, Eric J Costanzo, James Cosentino, Chirag Patel, Asa Dewan, Yen-Hong Kuo, Loay Salman, Tushar J Vachharajani
BACKGROUND: While transradial approach to conduct percutaneous coronary interventions offers multiple advantages, the procedure can cause radial artery damage and occlusion. Because radial artery is the preferred site for the creation of an arteriovenous fistula to provide dialysis, patients with chronic kidney disease are particularly dependent on radial artery for their long-term survival. METHODS: In this retrospective study, we investigated the prevalence of chronic kidney disease in patients undergoing coronary interventions via radial artery...
March 1, 2018: Journal of Vascular Access
Annamaria Dachille, Amelia Focaccio, Lucio Selvetella, Giovanni Napolitano, Carlo Briguori
Although there is not uniform definition of high-risk percutaneous coronary intervention (PCI), patients with severe three-vessel disease, left main disease, single remaining patent vessel and/or depressed left ventricular ejection fraction are considered a high-risk population. In this setting, periprocedural hemodynamic instability represents a serious issue. Percutaneous mechanical circulatory support (MCS) devices may improve both safety and efficacy of high risk PCI. Indeed, MCS help to maintain coronary perfusion pressure and reduce myocardial workload, providing the operator sufficient time to reach the target of complete revascularization...
March 8, 2018: Minerva Cardioangiologica
Elizabeth Curtis, Ritin Fernandez, Astin Lee
OBJECTIVE: The objective of this review was to identify the effectiveness of topical medications on radial artery spasm (RAS) in patients undergoing transradial percutaneous coronary procedures. INTRODUCTION: Percutaneous coronary procedures were traditionally carried out via the femoral artery; however, over the last 20 years there has been a global increase in the number of proceduralists carrying out percutaneous coronary procedures via the transradial approach...
March 2018: JBI Database of Systematic Reviews and Implementation Reports
Carmelo Panetta, Sunil Rao
OBJECTIVES: Study a novel method using manual pressure on a hemostatic pad and hemoband for ulnar compression as a potential alternative for radial sheath removal. BACKGROUND: The standard for transradial access site (TRA) sheath removal requires an inflatable pressure band over the radial artery and recently a band over the ulnar artery to reduce complications. We present a novel technique using a SoftSeal®-STF hemostatic pad over the radial artery combined with a hemoband over the ulnar artery after sheath removal...
March 9, 2018: Catheterization and Cardiovascular Interventions
Mario Gaudino, Francesco Burzotta, Faisal Bakaeen, Olivier Bertrand, Filippo Crea, Antonino Di Franco, Stephen Fremes, Ferdinand Kiemeneij, Yves Louvard, Sunil V Rao, Thomas A Schwann, James Tatoulis, Robert F Tranbaugh, Carlo Trani, Marco Valgimigli, Pascal Vranckx, David P Taggart
This article summarizes the current research on the benefits of using the transradial approach for percutaneous procedures and the radial artery as a conduit for coronary artery bypass surgery. Based on the available evidence, the authors provide recommendations for the use of the radial artery in patients undergoing percutaneous or surgical coronary procedures.
March 13, 2018: Journal of the American College of Cardiology
Sandhya Reddy, Pariseema S Pancholy, Kaveet P Pandya, Anvit Rai, Aman T Patel, Siddharth Chauhan, Ian C Gilchrist
OBJECTIVES: Evaluation of plethysmography as a reliable triage tool to access collateral circulation in the hand prior to transradial access. BACKGROUND: Hand plethysmographic testing has been used for access site triage prior to cardiac catheterization despite a lack of data supporting its result's stability. METHODS: Cohort of consecutive outpatients presenting for evaluation prior to cardiac catheterization underwent hand plethysmographic testing at the beginning of the office visit and before discharge...
March 2, 2018: Cardiovascular Revascularization Medicine: Including Molecular Interventions
George Hahalis, Grigorios Tsigkas, Nikos Kounis, Sotirios Patsilinakos, Nikolaos Kafkas, Antonios Ziakas, Nikolaos Patsourakos, George Almpanis, Ioanna Koniari, Ioanna Xanthopoulou, Nikolaos Koutsogiannis, Stefanos Despotopoulos, Marianna Leopoulou, Vasiliky Tassi, Ioannis Miliordos, Maria Anastasopoulou, Anastasios Roumeliotis, Athina Dapergola, Konstantinos Aznaouridis, Dimitrios Chatzis, Periklis Davlouros
Radial artery (RA) occlusion (RAO) remains the Achilles heel of transradial coronary procedures. Although of silent nature, RAO is relatively frequent, results in graft shortage for future coronary artery bypass surgery, and may occur even after short-lasting, 5F coronary angiography (CAG). The most frequent predictors of RAO are RA size, body size, female gender, and periprocedural anticoagulation intensity. Methods to detect RAO are variable, of which the Barbeau test and ultrasonography have similar diagnostic accuracy...
January 1, 2018: Angiology
Michael Koutouzis, George S Sfyroeras, Christos Maniotis, Konstantinos Kintis, Sotirios Patsilinakos, Panagiotis Tsiverdis, Giannis Giannikouris, Ioannis Tsiafoutis, Efstathios Lazaris, Michalis Hamilos
BACKGROUND: End-stage renal disease (ESRD) is considered a relative contraindication for forearm (radial or ulnar) cardiac catheterization. However, in everyday practice, many ESRD patients are catheterized from the forearm. The aim of this study was to compare femoral and forearm approach for cardiac catheterization in ESRD patients. METHODS: All cardiac catheterization procedures performed in ESRD patients in three Greek hospitals in a 2-year period (2014-2015) were retrospectively evaluated...
March 2018: Journal of Invasive Cardiology
Ali Elfandi, Jordan G Safirstein
PURPOSE OF REVIEW: The evolution of cardiac catheterization has led to the development of well-refined, more effective, and safer devices that allow cardiovascular interventionalists to deliver high-quality percutaneous interventions (PCI). Transradial PCI (TRI) has gained more popularity in the USA over the past 10 years, and as experience and volume of TRI grow, studies adopting same day radial PCI protocols have emerged and are showing promising results. We sought to review the current literature on TRI and same day discharge (SDD)...
February 24, 2018: Current Treatment Options in Cardiovascular Medicine
Matthew S Schoenfeld, Ibrahim Kassas, Binita Shah
Early revascularization is the gold standard for management of patients with ST-elevation myocardial infarction (STEMI) and cardiogenic shock (CS). The use of transradial artery access (TRA) in percutaneous coronary intervention (PCI) has increased in recent years and has emerged as a safe and effective approach to PCI in high-risk patients, with advantages in reduced major bleeding events, other peri-procedural complications, and all-cause mortality when compared with transfemoral artery access (TFA). Multiple randomized clinical trials have demonstrated these advantages of TRA vs...
February 24, 2018: Current Treatment Options in Cardiovascular Medicine
Piotr Kübler, Wojciech Zimoch, Michał Kosowski, Brunon Tomasiewicz, Artur Telichowski, Krzysztof Reczuch
INTRODUCTION: Transfemoral approach (TFA) may be preferred access site in order to facilitate complex percutaneous procedures such as rotational atherectomy (RA). Notwithstanding, there is a growing evidence that transradial approach (TRA) is associated with lower access site complication rates and even lower mortality. The aim was to assess in-hospital and 1-year outcomes in patients undergoing RA using TRA, in comparison to TFA. METHODS: A single center observational study included all consecutive patients, who underwent RA from 2010 to 2015...
February 21, 2018: Journal of Interventional Cardiology
Akihiro Nakamura, Masanori Kanazawa, Kazuki Noda, Hideaki Endo, Tohru Takahashi, Eiji Nozaki
The percutaneous transradial artery approach for coronary angiography and intervention has been recognized as a safe and effective method, however, it is limited for endovascular therapy (EVT) for femoro-popliteal artery because of lack of devices with longer shaft. Herein, we report two EVT cases for superficial femoral artery disease treated with a long shaft balloon through the radial artery. Although femoro-popliteal artery intervention with this approach has several limits for available devices and technical issues, it is effective for particular patients who are impossible in EVT with femoral artery approach...
January 2018: Indian Heart Journal
Sasko Kedev, Biljana Zafirovska, Slobodan Antov, Jorgo Kostov, Igor Spiroski, Marjan Boshev, Ivan Vasilev, Aleksandar Jovkovski, Hajber Taravari, Darko Kitanoski, Danica Petkoska, Kalon K L Ho
No abstract text is available yet for this article.
December 24, 2017: Cardiovascular Revascularization Medicine: Including Molecular Interventions
Adel Aminian, Shigeru Saito, Akihiko Takahashi, Ivo Bernat, Robert Lee Jobe, Takashi Kajiya, Ian C Gilchrist, Yves Louvard, Ferdinand Kiemeneij, Niels van Royen, Maarten van Leeuwen, Seiji Yamazaki, Takashi Matsukage, Juan F Iglesias, Sunil V Rao
BACKGROUND: During transradial (TR) access, it remains unclear whether differences in baseline patients characteristics and hemostasis care impact the rate of radial artery occlusion (RAO). We sought to compare the rate of RAO after TR access with the 6 French(Fr) Glidesheath Slender (GSS6Fr, Terumo, Japan) or a standard 5 Fr sheath in Japanese and non-Japanese patients. METHODS AND RESULTS: The Radial Artery Patency and Bleeding, Efficacy, Adverse evenT (RAP and BEAT) trial randomized 1,836 patients undergoing TR coronary angiography and/or interventions to receive the GSS6Fr or the standard 5 Fr Glidesheath (GS5Fr, Terumo, Japan)...
February 16, 2018: Catheterization and Cardiovascular Interventions
Neal S Kleiman
No abstract text is available yet for this article.
February 2018: Circulation. Cardiovascular Interventions
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