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The distal left radial artery access for coronary angiography and intervention: A new era
- Source :
- Cardiovascular revascularization medicine : including molecular interventions. 19(8S)
- Publication Year :
- 2018
-
Abstract
- Background Patients' intra and post procedural comfort, quick recovery, as well as procedure success, are key elements for choosing the right arterial access site. Radial artery access has been of increasing interest since it was first described. Advanced treatments of coronary lesions, from primary percutaneous interventions during ST elevation myocardial infarction cases to chronic total occlusion cases, have been increasingly done through the radial access. Distal left trans radial artery (dlTRA) is a new technique first described by Kiemineij. We report the first documented US experience of the left distal radial artery access for coronary angiography and interventions. Methods dlTRA was attempted on 22 consecutive patients, consented for a cardiac catheterization . 7 patients underwent percutaneous coronary intervention. The left hand is prepped in the usual fashion, exposing the anatomical snuff box. Under ultrasound guidance, the artery is punctured and the sheath is inserted carefully. The cardiac catheterization is completed using standard diagnostic and guiding catheters, that are typically chosen for femoral artery access. Hemostasis was achieved with a radial band. Patients had the ability to use the right hand as well as bend their left wrist post procedure. Results dlTRA was successful in all 22 patients. 7 patients underwent PCI through this approach. Two patients required a multivessel complex PCI with multiple stents and additional equipment. There were no conversions to the right radial or femoral approach. All patients had excellent hemostasis with a radial band, with no complications. Pre discharge radial pulses were intact in the wrist as well as in the anatomical snuff box. Conclusion Distal left trans radial access is feasible and safe in patients that are carefully selected and are deemed good candidates. There is a learning curve for developing such program, as is the case with conventional radial access.
- Subjects :
- Male
medicine.medical_specialty
Cardiac Catheterization
Percutaneous
medicine.medical_treatment
Arterial Access Site
Femoral artery
Coronary Artery Disease
030204 cardiovascular system & hematology
Coronary Angiography
Anatomical snuffbox
03 medical and health sciences
0302 clinical medicine
Percutaneous Coronary Intervention
medicine.artery
medicine
Humans
Radial artery
Cardiac catheterization
medicine.diagnostic_test
business.industry
Percutaneous coronary intervention
General Medicine
Middle Aged
Coronary Vessels
Surgery
medicine.anatomical_structure
Angiography
Radial Artery
Cardiology and Cardiovascular Medicine
business
030217 neurology & neurosurgery
Follow-Up Studies
Subjects
Details
- ISSN :
- 18780938
- Volume :
- 19
- Issue :
- 8S
- Database :
- OpenAIRE
- Journal :
- Cardiovascular revascularization medicine : including molecular interventions
- Accession number :
- edsair.doi.dedup.....256966e2447969c7a48f25044735803f