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Transradial angiography

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
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
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
Craig A Mounsey, Jamie A Mawhinney, Raphael S Werner, David P Taggart
The radial artery (RA) is a commonly used conduit for coronary artery bypass grafting, and recent studies have demonstrated that it provides superior long-term patency rates to the saphenous vein in most situations. In addition, the RA is also being used with increasing frequency as the access point for coronary angiography and percutaneous coronary interventions. However, there has been concern for many years that these transradial procedures may have a detrimental impact on the function of RA grafts used in coronary artery bypass grafting, and there is now comprehensive evidence that such interventions cause morphologic and functional damage to the artery in situ...
August 30, 2016: Circulation
S Kilic, R S Hermanides, J P Ottervanger, E Kolkman, J H E Dambrink, V Roolvink, A T M Gosselink, E Kedhi, A W J van 't Hof
AIM: This study sought to assess whether radial artery access improves clinical outcomes in patients presenting with acute myocardial infarction compared with femoral artery access. METHODS: This is a single-centre, prospective observational registry of all STEMI and NSTEMI patients who underwent coronary angiography and/or primary PCI in the period January 2010 to December 2013. Primary endpoint was 30-day all-cause mortality. Choice of access was left to the discretion of the cardiologist...
August 25, 2016: Netherlands Heart Journal
Li Zhu, Jianming Xu, Qibing Wang, Fei Xu, Jun Chen
BACKGROUND: Coronary heart disease is common in the general population and is estimated to cause as many deaths worldwide as cancer. Percutaneous coronary angiography and intervention is the most common method in the diagnosis and treatment of coronary heart disease. To achieve best practice in the nursing care of transradial angiography and intervention, there is an urgent need for clinical knowledge. OBJECTIVES: This aim of this project was to improve clinical nursing care for transradial angiography and intervention in Zhongshan Hospital, Shanghai...
May 2016: JBI Database of Systematic Reviews and Implementation Reports
Avtandil M Babunashvili, Samir B Pancholy, Dmitriy S Kartashov
We report a new technique for treatment of radial artery pseudoaneurysm (RAP) caused by transradial access (TRA) for coronary angiography. Traditional extrinsic compression with radial flow cessation leads to a local milieu likely associated with an increase in probability of radial artery occlusion (RAO). Our technique involves obtaining ipsilateral radial artery access distal to the neck of the RAP followed by a prolonged sheath dwell time covering the neck of the RAP which allows the RAP sac to thrombose and maintains radial artery lumen patency...
August 16, 2016: Catheterization and Cardiovascular Interventions
David Allen, Hilary Bews, Minh Vo, Malek Kass, Davinder S Jassal, Amir Ravandi
Arteria Lusoria or aberrant right subclavian artery (ARSA) is present in 0.6-1.4% of individuals. It typically remains clinically silent and is often discovered during angiographic procedures. The presence of ARSA can make a right transradial approach for coronary angiography and angioplasty technically more difficult. With the use of catheter support, we describe two cases in which a right transradial approach for catheterization was successful in the setting of ARSA. As such, the presence of ARSA does not warrant abandoning a transradial approach for coronary angiography and angioplasty...
2016: Case Reports in Cardiology
Renatomaria Bianchi, Ludovica D'Acierno, Mario Crisci, Donato Tartaglione, Maurizio Cappelli Bigazzi, Mario Canonico, Michele Albanese, Felice Gragnano, Fabio Fimiani, Mariagiovanna Russo, Plinio Cirillo, Paolo Calabrò
Since the first cardiac catheterization in 1929, this procedure has evolved considerably. Historically performed via the transfemoral access, in the last years, the transradial access has been spreading gradually due to its many advantages. We have conducted a review of published literature concerning efficacy, safety, and cost-effectiveness, and we analyzed our patients' data, including the results of the recently published Minimizing Adverse hemorrhagic events by TRansradial access site and systemic implementation of angioX (MATRIX) study...
July 11, 2016: Angiology
Samir Sur, Brian Michael Snelling, Dileep Yavagal, Eric C Peterson
INTRODUCTION: Widely adopted by interventional cardiology, radial access has seen slower adoption in neurointerventional procedures despite its proven increased safety and patient satisfaction. Based on our positive initial experience with radial access, as well as increased patient satisfaction, we adopted a "radial first" policy for diagnostic angiography. We present our initial experience transitioning from the traditional transfemoral approach to a radial-first approach. METHODS: Procedural data were reviewed from 103 consecutive transradial diagnostic cerebral angiograms performed between November 2015 and February 2016...
August 2016: Neurosurgery
Jeffrey M Schussler, Anupama Vasudevan, Liana J von Bose, Jane I Won, Peter A McCullough
Transradial artery (TRA) approach is associated with fewer vascular complications and reduced mortality in patients at high risk compared with transfemoral approach (TFA). The objective of our study was to compare the characteristics and outcomes of patients who had coronary angiography by TRA and TFA over the course of hospital implementation of this approach. We included 12,928 patients from Baylor University Medical Center and Baylor Heart and Vascular Hospital, Dallas, Texas, who underwent a coronary angiography from January 2008 to March 2015...
August 15, 2016: American Journal of Cardiology
Binita Shah, Joseph Burdowski, Yu Guo, Bryan Velez de Villa, Andrew Huynh, Meena Farid, Mansi Maini, Claudia Serrano-Gomez, Cezar Staniloae, Frederick Feit, Michael J Attubato, James Slater, John Coppola
Left transradial approach (TRA) for coronary angiography is associated with lower radiation parameters than right TRA in an all-comers population. The aim of this study was to determine the effects of left versus right TRA on radiation parameters in patients with predictors of TRA failure. Patients with predictors of TRA failure (≥3 of 4 following criteria: age ≥70 years, female gender, height ≤64 inches, and hypertension) referred to TRA operators were randomized to either right (n = 50) or left (n = 50) TRA, whereas those referred to transfemoral approach (TFA) operators were enrolled in a prospective registry (n = 50)...
August 15, 2016: American Journal of Cardiology
Khaled Sherif, Yasir Yaqub, Jose A Suarez
OBJECTIVE: We present a case of chronic total occlusion (CTO) approached with LASER endovascular intervention by radial artery approach using a 5 French sheath. CASE REPORT: A 57-year-old man presented to our hospital having had retrosternal chest pain for two days. Physical examination was normal at the time of presentation. The laboratory tests were within normal limits, including cardiac enzymes except the lipid panel which showed hypertriglyceridemia. The patient underwent a myocardial perfusion scintigraphy stress test that revealed inferior wall ischemia, with normal left ventricular ejection fraction...
May 2016: Acta Medica Academica
On Chen, Sunny Goel, Michael Acholonu, Guy Kulbak, Shivani Verma, Efstratios Travlos, Richard Casazza, Elliot Borgen, Bilal Malik, Michael Friedman, Norbert Moskovits, Robert Frankel, Jacob Shani, Sergey Ayzenberg
In this prospective, randomized controlled study, we aim to compare the performance outcomes of standard catheters with the radial artery-specific catheter. Over the past decade, transradial cardiac catheterization has gained widespread popularity because of its low complication rates compared with transfemoral access. Operators have the choice of using either standard catheters (used for both transfemoral and transradial approach, with need for separate catheter use for either right or left coronary artery engagement) or a dedicated radial artery catheter, which is specifically designed to engage both coronary arteries through radial artery access...
August 1, 2016: American Journal of Cardiology
Trevor Simard, Benjamin Hibbert, Madhu K Natarajan, Mathew Mercuri, Simon L Hetherington, Robert Wright, Ronak Delewi, Jan J Piek, Ralf Lehmann, Zoltán Ruzsa, Helmut W Lange, Håkan Geijer, Michael Sandborg, Vinay Kansal, Jordan Bernick, Pietro Di Santo, Ali Pourdjabbar, F Daniel Ramirez, Benjamin J W Chow, Aun Yeong Chong, Marino Labinaz, Michel R Le May, Edward R O'Brien, George A Wells, Derek So
BACKGROUND: The adoption of the transradial (TR) approach over the traditional transfemoral (TF) approach has been hampered by concerns of increased radiation exposure-a subject of considerable debate within the field. We performed a patient-level, multi-center analysis to definitively address the impact of TR access on radiation exposure. METHODS AND RESULTS: Overall, 10 centers were included from 6 countries-Canada (2 centers), United Kingdom (2), Germany (2), Sweden (2), Hungary (1), and The Netherlands (1)...
June 2016: Journal of the American Heart Association
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