TY - JOUR. T1 - Transradial coronary intervention. T2 - Comparison of the left and right radial artery approach. AU - Kim, Jang Young. AU - Yoon, Junghan. AU - Jung, Il Hyung. AU - Wang, Hee Sung. AU - Jung, Hyun Sook. AU - Yoo, Byung Su. AU - Lee, Seung Hwan. AU - Choe, Kyung Hoon. PY - 2006/12. Y1 - 2006/12. N2 - Background and Objectives: We evaluated the efficacy and safety of the left transradial approach as compared to the right radial approach when performing transradial coronary intervention. Subjects and Methods: We performed the transradial coronary intervention in 711 cases via the left approach (Lt. group) and in 614 cases via the right approach (Rt. group) for patients with a normal Allens test of both arms. We evaluated the procedural success rate, the crossover rate, the puncture time, the total procedural duration, the fluoros copy time, the amount of contrast agent used and the local vascular complications of both groups. Results: The baseline clinical and angiographic profiles ...
The aim of this study was to compare two hemostatic techniques, minimum pressure technique and patent hemostasis, on radial artery occlusion (RAO) after transradial catheterization.
Background: Remodeling of the radial artery (RA) after transradial percutaneous coronary intervention (TRI) is under studied. Objectives: To examine the impact of TRI on RA diameter and intimal-medial thickness (IMT) in men and women using 55 Mhz ultrahigh frequency duplex ultrasound (UHFDU). Methods: We performed UHFDU at 24 h and 90 days after non-emergent TRI in 41 patients (25 men, 16 women). Changes in RA diameter, IMT and RA injury were compared by patient gender. Multivariate linear regression was used to determine the predictors of RA diameter and IMT.
BACKGROUND The transradial approach for percutaneous coronary procedures has the advantage of reduced access site complications but is associated with specific technical challenges in comparison with the transfemoral approach. Transradial procedure failures can sometimes be due to variation in radial artery anatomy. However, data describing such variations are limited. OBJECTIVE To evaluate the incidence and impact of radial artery anomalies in patients undergoing transradial coronary procedures. METHODS Retrograde radial arteriography was performed in all patients presenting for a first-time radial procedure. Patient characteristics, radial artery anatomy and procedural outcome were assessed. RESULTS 1540 consecutive patients were studied, 70.6% male, mean (SD) age 63.6 (11.1) years. The overall incidence of radial artery anomaly was 13.8% (n = 212). 108 (7.0%) patients had a high-bifurcating radial origin, 35 (2.3%) had a full radial loop, 30 (2.0%) had extreme radial artery tortuosity and 39 (2
Transradial approach has gained progressive acceptance because it has been shown to have fewer hemorrhagic and vascular-related complications than the femoral approach does for diagnostic and therapeutic percutaneous coronary artery procedures. However, transradial access is not free of complications (1). A 43-year-old man was admitted with a non-ST-segment elevation acute coronary syndrome. A transradial coronary angiography was performed, followed by a drug-eluting stent implantation in the proximal descendent artery. Twenty-four hours after the procedure, he experienced an intense, continuous chest pain in his right upper hemi-thorax that irradiated to the right forearm, without electrocardiographic changes or elevated markers of myocardial damage, and required a high dose of analgesia. A computed tomogram was performed, revealing a subclavian artery pseudoaneurysm that compressed the brachial plexus (Figs. 1A to 1D). A few days later, an endovascular covered self-expanding stent was ...
U.S., Feb. 9 -- ClinicalTrials.gov registry received information related to the study (NCT03042845) titled Randomized Comparison of JUDkins vs tiGEr Catheter in Coronary Angiography Via the Right Radial Artery: the JUDGE Study on Feb. 1. Brief Summary: The investigators aim to assess safety and efficiency of Tiger II (5Fr; Terumo Interventional Systems, Somerset, New Jersey) vs Judkins (5Fr; 3.5L/4R, Medtronic Co) catheters, in coronary angiography via the right transradial route. This is a prospective, randomized, study of parallel design. Consecutive patients with acute coronary syndrome (ACS), eligible for non-urgent coronary angiography, are randomized after successful cannulation of right radial artery and informed consent to either Tigger II or Judkins 3.5L/4R catheters. Study Start Date: Study Type: Interventional Condition: Coronary Artery Disease Intervention: Device: Tiger cardiac catheter Tiger cardiac catheter Device: Judkins 3.5L/4R cardiac catheters Judkins 3.5L/4R cardiac ...
Our study shows that in patients with mild CHF radial artery compliance was less than in control normotensive and hypertensive subjects. However, it also shows that in these patients 4- and 8-week administrations of benazepril at a dose that clearly interfered with the renin-angiotensin system were accompanied by an increase in arterial compliance that made its values similar to those of the two control groups, in which an observational period or ACE inhibitor treatment of similar duration had no effect. This provides the first evidence that the reduction of radial artery compliance occurring in mild CHF1 2 is not irreversible. On the contrary, this reduction is improved by ACE inhibitor treatment, and the improvement can be such as to quickly, completely, and persistently reverse the compliance alteration characterizing this condition.1 2 The mechanisms responsible for the impairment of radial artery compliance in CHF patients are not known. However, it can be suggested that the impairment may ...
Transradial catheterization is an endovascular procedure or catherization procedure performed to diagnose and treat arterial disease (e.g., coronary artery disease, peripheral artery disease, etc.). Endovascular procedure can be performed achieving access in to bodys arterial system from either femoral artery (in groin), brachial artery (in elbow) or radial artery in the wrist. The transfemoral (through groin) approach to perform cardiac catheterization has typically been more prevalent in invasive cardiology. But, radial access has gained in popularity due to technical advances with catheters and lower complication rates than transfemoral access. In 1948, Radner published one of the first descriptions of transradial central arterial catheterization and attempts at coronary artery imaging using radial artery cut-down. Transradial access to perform diagnostic cardiac catheterization procedures was introduced by Campeau and was later adapted for therapeutic procedures of coronary angioplasty by ...
Our results demonstrate a statistically significant and clinically relevant reduction in the incidence of 30-day RAO using prophylactic ipsilateral ulnar artery compression while compressing the radial artery for hemostasis after TRA. In fact, using that prophylactic technique, RAO was significantly reduced at all time intervals. With a rapidly growing adoption of TRA worldwide with a large mix of operators at several stages of the learning curve and increasing patient as well as procedural complexity, RAO prevention should take center stage to preserve the safest access site in a patient with a chronic recurrent illness such as atherosclerotic vascular disease.. Presence of radial artery patency during hemostatic compression has been shown to be associated with a lower incidence of RAO (25). Patent hemostasis, defined as persistence of antegrade flow in the radial artery during hemostatic compression, has been shown to significantly lower the incidence of RAO (14). However, it is achieved in ...
The aim of this study is to measure radiation exposure during coronary angiography (CA) with a trans-radial approach (TRA), specifically comparing access via the left versus right radial artery in patients with suggested clinical predictors of TRA failure/difficult. These predictors include age ,70, female gender, height ,64 inches, and history of hypertension.The study also aims to determine difficulties encountered during left or right radial access in this specific patient population. A secondary aim is to compare the results of enrolled patients with a registry of patients where femoral access was obtained.. Currently more than 1 million percutaneous coronary interventions (PCI) are performed in the United States annually. There is a growing trend to perform procedures utilizing the TRA due to recent data demonstrating decreased bleeding and access-site complications compared to the femoral approach. However, the TRA approach is also know to be associated with greater radiation exposure ...
Transradial cardiac catheterization is a procedure used to treat and diagnose certain heart conditions. It is also known as transradial cardiac cath.
... is a procedure used to treat and diagnose certain heart conditions. It is also known as transradial cardiac cath.
TY - JOUR. T1 - Use of a harvested radial artery graft with preservation of the vena comitantes to reduce spasm risk and improve graft patency for extracranial to intracranial bypass. T2 - Technical note. AU - El Tecle, Najib E.. AU - Zammar, Samer G.. AU - Hamade, Youssef J.. AU - El Ahmadieh, Tarek Y.. AU - Aoun, Rami James N. AU - Nanney, Allan D.. AU - Batjer, Hunt H.. AU - Dumanian, Gregory A.. AU - Bendok, Bernard. PY - 2016/3/1. Y1 - 2016/3/1. N2 - Background and significance: The vessels of choice for cerebrovascular high-flow direct bypass procedures are the radial artery and the saphenous vein. Radial artery grafts have become favored over saphenous vein grafts because of higher patency rates and better size matching to appropriate recipient vessels. Radial grafts are prone to spasm however, and this may be seen in 4-10% of cases and can be associated with ischemic sequelae. The standard technique for radial artery harvest calls for complete separation of the artery from its ...
We read with great interest the recently published review of Rao et al. (1) regarding the clinical benefits of using the transradial approach for percutaneous coronary interventions (PCI). The paper outstandingly demonstrates how deeply a technical modification might influence our current clinical practice. Despite these benefits, the paper attracts the readers attention to the low adoption rate of this technique that is primarily supplied by the fears and thoughts from the learning curve of the undevoted operators. In the current correspondence, we would like to extend the Rao et al. (1) discussion with the findings of 2 recent observations.. Rao et al. (1) cited and discussed 2 comprehensive meta-analyses of randomized comparisons between the transradial PCI and transfemoral PCI approaches (2,3). Although these studies demonstrated a significant reduction in bleeding- and access site-related complications, they failed to find a significant link between the frequency of adverse cardiovascular ...
Radial artery puncture is frequently performed in many EDs. Arterial blood gas analysis and invasive blood pressure monitoring require radial artery puncture. The radial artery is favored because of the existence of the collateral and ulnar arteries as well as the ease of access. The radial artery is also a popular access site for coronary angiography and cerebral angiography. Doppler ultrasonography or a modified Allens test can be used to evaluate the patency of collateral flow. However, the efficacy of the Allens test remains under debate [3,4].. Common complications after radial artery cannulation include temporary radial artery occlusion (19.7%), hematoma (14.4%), infection (0.72%), hemorrhage (0.53%), and bacteremia (0.13%). The complications described herein-permanent ischemic damage and pseudoaneurysm-are very rare adverse effects, with rates of 0.09% each [1]. Risk factors for complications involve the cannula size, vasospasm, patient age, female sex, high number of puncture attempts, ...
Importance: Observational studies have suggested that the use of radial artery grafts for coronary artery bypass grafting may improve clinical outcomes compared with the use of saphenous vein grafts, but this has not been confirmed in randomized trials.. Objective: To compare clinical outcomes between patients receiving radial artery vs saphenous vein grafts for coronary artery bypass grafting after long-term follow-up.. Design, Setting, and Participants: Patient-level pooled analysis comparing radial artery vs saphenous vein graft in adult patients undergoing isolated coronary artery bypass grafting from 5 countries (Australia, Italy, Serbia, South Korea, and the United Kingdom), with enrollment from 1997 to 2009 and follow-up completed in 2019.. Interventions: Patients were randomized to undergo either radial artery (n = 534) or saphenous vein (n = 502) grafts for coronary artery bypass grafting.. Main Outcomes and Measures: The primary outcome was a composite of death, myocardial infarction, ...
Recent advances in technology have made it possible to perform this second procedure in a new way, through endoscopic small incision surgery. This new procedure results in less muscle and tissue damage when removing the vessel graft. This may eliminate many of the complications associated with the former technique, which required a long incision the length of the graft.. In the past a vessel was often removed from the patients leg, called a saphenous vein graft. Now surgeons may choose to remove the radial artery in the patients forearm instead.. To harvest the radial artery the surgeon makes two small one-inch incisions in the patients forearm. One incision is made near the wrist; the other is made near the elbow.. Because radial arteries from the arm are accustomed to higher blood pressure than leg veins, they may prove to be more durable bypass grafts. In the past surgeons had to harvest the radial artery through a long incision from the elbow to the wrist, increasing the potential for ...
Our results obtained from humans demonstrate that KCa channels are involved in regulation of the mechanical properties of peripheral conduit arteries, supporting a role for EDHF at this level in vivo. In addition, the synergistic effect of l-NMMA and TEA on radial artery constriction and arterial wall stiffening in absence of such effects after administration of l-NMMA alone shows that KCa channels compensate for the loss of NO synthesis to maintain peripheral conduit artery diameter and mechanics.. The present study was performed in healthy subjects at the level of the radial artery to assess in vivo the role of NO and vascular KCa channels and their potential interaction in the regulation of basal conduit artery diameter and mechanics. All experiments were performed after administration of aspirin to inhibit vascular cyclooxygenase and to exclude a role for PGI2 in our results.15,24 The inhibition of endothelial NO synthesis was obtained with l-NMMA, infused at a dose of 8 μmol/min, known to ...
The radial artery, which is located on the outer side of the forearm, can be used in interventional procedures, such as cardiac catheterization, to provide access to the arterial blood supply. In order to facilitate successful catheterization of the artery, a dilated artery and one free of arterial spasm is desirable. The proposed study will randomize twenty three healthy subjects to determine the effect of topical nitroglycerin on radial artery vasodilation. In the first phase of the study, which is a dose escalation study, each subject will receive either one or two inches of nitroglycerin in a blinded manner on one wrist and placebo on the other. Radial artery diameter will be measured with ultrasound at regular intervals up to two hours. The subjects will then return at a later date at which point they will receive the alternate dose on one wrist and placebo on the other. In the second phase of the study, we will randomize the same patients to a mixture of topical nitroglycerin and lidocaine ...
theheart.org has a short but instructive video discussion on radial access. Some discussion points: pre-procedural testing: recent trial data suggests that low risk of occlusion and complications even in patients with poor integrity palmar arch assessed Barbos palmar arch testing. procedural: adjunctive heparin reduces risk of radial artery occlusion standard dose of herpain 5000 units…
It has been reported that Gaussian functions could accurately and reliably model both carotid and radial artery pressure waveforms (CAPW and RAPW). However, the physiological relevance of the characteristic features from the modeled Gaussian function
OBJECTIVES: There is an increasing use of arterial conduits for coronary artery bypass grafting, and the radial artery is commonly used as the third graft. The major drawback of the radial artery is its proclivity to spasm. Both papaverine and phenoxybenzamine have been recommended as topical vasodilators in clinical practice. We compared the efficacy of both drugs to prevent radial artery spasm and their ability to preserve endothelial function. METHODS: The ability of both drugs to prevent alpha-adrenoreceptor mediated constriction was tested in vitro in an organ bath in radial artery segments obtained from 20 patients. Vessel viability was determined by potassium (K(+)) constriction, and endothelial function was assessed by observing endothelium-dependent relaxation by a synthetic analogue of acetylcholine, carbachol. RESULTS: Papaverine consistently abolished and prevented spasm for up to a maximum of 30 min in all segments. In contrast, phenoxybenzamine consistently abolished and prevented radial
In human anatomy, the radial artery is the main artery of the lateral aspect of the forearm. The radial artery arises from the bifurcation of the brachial artery in the antecubital fossa. It runs distally on the anterior part of the forearm. There, it serves as a landmark for the division between the anterior and posterior compartments of the forearm, with the posterior compartment beginning just lateral to the artery. The artery winds laterally around the wrist, passing through the anatomical snuff box and between the heads of the first dorsal interosseous muscle. It passes anteriorly between the heads of the adductor pollicis, and becomes the deep palmar arch, which joins with the deep branch of the ulnar artery. Along its course, it is accompanied by a similarly named vein, the radial vein. The named branches of the radial artery may be divided into three groups, corresponding with the three regions in which the vessel is situated. Radial recurrent artery - arises just after the radial artery ...
BACKGROUND: Transradial percutaneous coronary intervention (PCI) offers important advantages over transfemoral PCI, including better outcomes. However, when there is indication to ad hoc PCI, a 6 French workflow is a common default strategy, hence potentially influencing vascular access selection in patients with anticipated small size radial artery. METHODS: A multidimensional evaluation was performed to compare two ad hoc interventional strategies in women ,160cm: a full 6 French workflow (namely 6 French introducer sheath, diagnostic catheters and guiding catheter) with a modified workflow consisting in the use of 5 French diagnostic catheters preceded by the placement of a 6 French sheath introducer and followed by a 6 French guiding catheter use for PCI ...
After returning home, her fingers turned pale and eventually started to show a bluish discoloration (Fig. 1). The pain became intolerable; therefore, she visited our ED, 12 hours after the procedure. Her initial vital signs were as follows: blood pressure, 127/77 mmHg; heart rate, 101/min; respiratory rate, 16/min; and body temperature, 36.7°C. Although seemed stable, she complained of excessive pain (8/10 on the numeric rating scale) in her left second and third fingers. A physical examination revealed significant sensory deterioration and coldness on the affected sites. Puncture marks were visible near her radial artery. Emergency Doppler ultrasonography performed in the ED showed normal blood flow from her radial artery to the common palmar digital artery. Decreased flow at the second and third proper palmar digital arteries was also found. Computed tomography angiography showed a pseudoaneurysm in her left radial artery and no sign of blood flow from her palmar digital artery (Fig. 2). A ...
Diabetes predicts worse outcomes after coronary artery bypass grafting (CABG) We hypothesized that a strategy using radial artery (RA) conduit(s) would improve outcomes and long term survival for diabetic patients undergoing CABG with Left Internal Thoracic Artery (LITA) and RA grafts, with or without additional saphenous vein (SV) when compared with outcomes for patients bypassed with LITA and SV but no RA. A propensity matched study of long term survival in diabetic patients who had isolated first time CABG from January 1995 to June 2010 at an urban academic medical center in New York City. Our primary endpoint was all cause mortality determined from the Social Security Death Index in December 2010. We compared our 15 year outcomes in diabetic patients after isolated, primary CABG: 642 patients received LITA + RA +/− SV (RA group) vs. 1201 patients who had LITA + SV only (SV group). Propensity scoring for multiple preoperative and operative variables matched 409 patients from each group: 68% were
This study was performed to investigate the impact of intima-media thickness (IMT) of radial artery on early failure of radiocephalic arteriovenous fistula (AVF) in hemodialysis (HD) patients. Ninety uremic patients undergoing radiocephalic AVF operation were included in this study. During the opera …
Introduction: Radial access for neurovascular procedures is rarely performed or even considered. There is increasing evidence from the interventional cardiology literature that radial access is associated with lower costs, lower incidence of myocardial infarction, stroke, decreased major access site complications, and even decreased mortality. Roadblocks for adopting or considering radial access for neurovascular procedures includes physician bias, physician training, and limitations in technology/devices. As we move towards a patient centered health care delivery, patient preference and complication rates should be considered. The 2 goals of this poster presentation are to provide a simplified approach to performing radial access for neurovascular and to present data on patient preference and outcomes for radial access.. Hypothesis: Radial access for neuro interventional procedures is preferred by patients over traditional femoral access and can be performed with a high degree of technical ...
Inserting the catheter through the radial artery in the wrist, rather than through the groin, has been shown to markedly reduce major vascular complications," said Imran Dar, M.D., an interventional cardiologist affiliated with Memorial Hermann Northwest. "Patients usually are able to sit up and walk around within two hours or less after the procedure, rather than lying down for many hours which was typical with the traditional method.". ...
This channel includes news, techniques and new technology innovations for radial access, also called transradial access or radial artery access. This concerns the location of introducer sheaths and vascular access for interventional procedures. Radial access is supported to result in fewer complications compared to femoral access.
BACKGROUND Data are limited regarding the clinical results of transradial coronary intervention (TRI) in acute myocardial infarction (AMI) complicated by cardiogenic shock. The aim of this study was to compare the clinical results of TRI and tr
The radial artery is a major artery in the human forearm. It is close to the surface of the underside of the forearm; when the palm of the hand is pointing upwards, so is the radial artery. The radial artery supplies the arm and hand with oxygenated blood from the
2. The superficial position of the distal radial artery, free of other anatomical structures, makes it easy to find and puncture, and safe to compress after sheath removal. A default radial approach is feasible in routine practice after appropriate training (both in stable and unstable patients including ST-segment elevation myocardial infarction [STEMI] patients), but proficiency in the femoral approach is required because it may be needed as a bailout strategy or when large guiding catheters are required. Better results with radial access are expected with increasing procedural volume of operators ...
our study was exclusively the comparison of rightand left-sided unilateral cerebral perfusion (UCP) for efficiency of cerebral protection rather than the suitability of a particular carotid artery for arterial return. The assessment of pressure in the left radial artery is of utmost importance in UCP, regardless if rightor leftsided perfusion is performed, because it reveals the efficiency of collateral pathways. As explained elaborately in the paper, our monitoring tools include therefore, amongst others, pressure measurement in both radial arteries. Nevertheless, the monitoring of the arterial return should not rely on the measurement of the pressure in the right radial artery alone, even if the right carotid or right axillary artery is cannulated with a side-graft, because the pressure is always higher on the directly perfused side. Cannulating the innominate artery that is very close to the aortic arch is surely the best haemodynamic, but for anatomo-pathological reasons, a rare option. Secondly,
This study demonstrates that ultrashort clamp release 20 minutes after cardiac catheterization via the TRA is not associated with reduction in the incidence of RAO compared with a short clamp release after 60 minutes. Rapid release required more frequent retightening of the clamp and was associated with higher incidence of hematomas. Moreover, retightening was an independent predictor of RAO and potentially was the cause of higher incidence of RAO in the ultrashort group.. Previous studies demonstrated that the incidence of RAO, when there is intention to use patent hemostasis, is reduced from 12% with 6 hours of compression to 5.5% with 2 hours of compression.9 More recently, Edris et al10 showed that a partial deflation of the TR Band (Terumo Medical) balloon after 15 minutes to allow patent hemostasis was associated with a reduction in the incidence of RAO from 14.9% to 2%. It should be highlighted, however, that among patients who had a standard deflation protocol, patent hemostasis was not ...
Coronary angiography is the standard study in the anatomical diagnosis of the coronary arteries and it´s introduced by Mason Sones in 1958, who ..
Jenkins, KJ et al. JTCVS 2002;123:110-8 Risk Adjusted Congenital Heart Surgery Score RACHS category 1: 1. Secundum ASD 2. Aortopexy ...
WASHINGTON, DC-A high-volume center accessing the coronary arteries via the radial artery safely discharged PCI patients home the same-day and significantly lowered the costs of the procedure when compared with an overnight stay, new research shows.. Presenting data at CRT 2017 in Washington, DC, William Rollefson, MD (Arkansas Heart Hospital, Little Rock) reported equivalent 30-day clinical outcomes among transradial PCI patients sent home the day of the procedure and patients who stayed overnight.. "When we looked at the cumulative costs in US dollars of transradial same-day discharge versus an overnight stay, the total cost in the same-day arm was $3,346," said Rollefson. "On average, the cost of the overnight stay was $4,682, which was an initial cost savings of $1,336, and this was slightly increased at 30-day follow-up.". Previous studies have shown patients can be safely discharged the same day after an uncomplicated PCI. For example, in a meta-analysis published in 2013, Olivier ...
TY - JOUR. T1 - Mortality after transradial approach in ST-segment elevation myocardial infarction. Do we see the forest for the trees?. AU - Komócsi, A.. AU - Tornyos, Adrienn. AU - Kehl, Dániel. AU - Aradi, D.. AU - Vorobcsuk, András. PY - 2013/10/3. Y1 - 2013/10/3. KW - Coronary intervention. KW - Mortality. KW - Transradial approach. UR - http://www.scopus.com/inward/record.url?scp=84885625019&partnerID=8YFLogxK. UR - http://www.scopus.com/inward/citedby.url?scp=84885625019&partnerID=8YFLogxK. U2 - 10.1016/j.ijcard.2013.04.104. DO - 10.1016/j.ijcard.2013.04.104. M3 - Article. C2 - 23664700. AN - SCOPUS:84885625019. VL - 168. SP - 3050. EP - 3053. JO - International Journal of Cardiology. JF - International Journal of Cardiology. SN - 0167-5273. IS - 3. ER - ...
In this issue of the Journal, Gaudino et al. (1) report on an interesting and fairly unique study describing the 20-year patency and outcomes in their initial series of 100 patients who received a radial artery (RA) graft, and who were prospectively followed. Previous long-term follow-up series of the RA as a coronary artery bypass graft (CABG) included those from Achouh et al. (2), Shi et al. (3), and the investigators of the Gaudino paper themselves (4). The main strength of the present study is the pre-specified systematic assessment of graft patency and RA harvest-related arm complications at specific time points, with a long period of follow-up.. All studies that deal primarily with long-term graft patency have inherent weaknesses. Because it is virtually impossible to have all patients return for long-term invasive coronary anatomy and graft assessment, various methodological approaches may be used to estimate true conduit patency. Some authors choose to ignore, that is "censor," patients ...
Knowledge about the vascular structure of upper extremity, both normal and abnormal, is important for diagnostic interventions and surgical procedures. During routine dissection of undergraduate teaching in the Department of Anatomy of JNMC, AMU, Aligarh, a unilateral variation in the origin of radial artery was noted on the right side. Third part of axillary artery gives rise to three branches, anterior circumflex humeral, posterior circumflex humeral and an anomalous common trunk for radial and subscapular artery. The aforementioned anomaly is first of its kind. High origin and superficial course of radial artery may be hazardous and vulnerable to injury during venepuncture and surgical approaches.. ...
Interventional cardiologists…listen up!!. Stent and angioplasty procedures in the United States are now done through the wrist 15-20% of the time. This is a big change!. Angioplasty.Org started its Transradial Center six years ago. At that time maybe 2-3% of procedures in the United States were done via the wrist. Virtually all diagnostic angiograms and PCIs (angioplasty or stent procedures) were being done via the femoral (leg/groin) artery, a technique invented and refined by Dr. Melvin Judkins over a half century ago.. It was in 1992 that Dutch cardiologist, Dr. Ferdinand Kiemeneij, performed the first angioplasty done via the wrist (transradial) approach. And it took a long time for his technique to filter through to the cardiology community. Currently the radial approach is utilized in 50% or more of procedures done in many European countries. And, while adoption of the wrist technique in the United States has definitely been behind Europe, today we are seeing 1 out of 6 procedures in the ...
Medical - Supplies - Bandages China, Offer The Radial Artery Compression Hemostat, Indications: Suitable for radial artery interventional surgery to stop the bleeding; Applicable department: Cardiology; ...
The radial artery approach is a well-established practice in coronary artery intervention. A recent study described its potential usefulness in neuroangiography, but its scope was limited to a single 4F catheter type, and it offered few procedural details that could facilitate adoption of the technique by those inexperienced with the transradial approach (11). Another group (14) reported excellent results in a cohort of similar size and also offered some details regarding the technique. Reports of transradial angiography for interventional neuroradiology are limited (10, 13). Our study broadens the current literature about transradial angiography by providing procedural details regarding patient assessment, access techniques, and catheter selection.. Our study findings confirm the utility of transradial angiography in diagnostic and interventional neuroangiographic procedures. Compared with the standard femoral and brachial approaches, this approach offers equal access to all relevant ...
Letters…we get letters.. Last month Dr. Oz did a segment on transradial angioplasty and featured Dr. Jennifer Tremmel who is not only the Clinical Director of Womens Heart Health at Stanford Clinic, but also the Director of Transradial Interventions at Stanford Medical Center. I reported on that show here.. There was much buzz generated in the cardiology community; after all, its not every day that many millions of viewers hear about an interventional cardiology procedure thats practiced in less than 10% of cases.. But while what Dr. Tremmel discussed was certainly of interest to Dr. Ozs lay audience, the story of how she came to practice the transradial approach is most instructive for those interventional cardiologists who are thinking about learning the radial technique. Briefly, she went to a course (with Dr. John Coppola in New York), came back to Stanford, and started doing radials right away. Within six months, her practice was 100% radial. You can read how this all came about ...
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In this large, national sample of veterans undergoing cardiac catheterization, we observed that transradial access was associated with: (1) slightly increased fluoroscopy times yet no increased used in contrast; (2) significantly lower rates of blood transfusion within 48 hours among patients with CKD, with increasing observed benefit with increasing severity of renal dysfunction; and (3) lower rates of progression to dialysis at 1 year, particularly among patients with severe CKD, compared with transfemoral access; this effect was not mediated by the decreased bleeding with transradial access. Therefore, the results of this study suggest that transradial access is associated with lower risk of periprocedural bleeding in CKD patients with greatest benefit in patients with severe CKD. Additionally, rates of progression to ESRD appear to be lower among transradial patients. These data suggest that transradial may be safer in patients with CKD; however, prospective, randomized trials in this ...
This study demonstrates that under normal physiological conditions, different types of flow stimulus elicit different mechanisms of conduit artery dilatation in humans. Dilatation, in response to transient increases in blood flow, is largely mediated by synthesis of NO, whereas sustained dilatation during a prolonged hyperemic stimulus is unaffected by L-NMMA, indicating an NO-independent mechanism. Furthermore, in patients with hypercholesterolemia, these pathways were differentially affected, with a selective abnormality only of the NO-dependent component. Our findings indicate that the mechanisms of conduit artery FMD in vivo are more complex than previously thought and have important implications for the design and interpretation of endothelial function tests and the treatment of vascular dysfunction in cardiovascular disease.. In the present study, pharmacological blockade of physiological pathways was used to probe the mechanisms that regulate radial artery diameter under different blood ...
Background: Limited information is available about the safety & efficacy of transradial (TR) versus transfemoral (TF) approach for percutaneous coronary angiography & interventions in the elderly.. Objective: The authors Aimed to conduct first ever comprehensive meta-analysis to evaluate the safety & efficacy of TR versus TF approach in the elderly.. Methods: The PubMed, Embase & CINAHL were searched for studies evaluating TR versus TF approach in the elderly (age≥75 years). The Stata software package was used to conduct more conservative random effect meta-analysis. Primary end point was access site complications (hematoma, pseudoaneurysm or need for access site surgery).. Results: Twelves studies (4 randomized & 8 observational) comprising 5636 patients met inclusion criteria for the review (Figure). The primary end point of access site complications was significantly lower in the TR group versus TF group (RR 0.23, 95% CI 0.15-0.34). The secondary end points of bleeding requiring blood ...
The authors experience demonstrates that access site complications are rare events with CAS despite the large diameter of implantable devices and liberal anticoagulant and antiplatelet therapy. Transbrachial and direct carotid approaches are relatively safe, accepted alternatives in the setting of …