Karim M Al-Azizi1, Vikram Grewal2, Kyle Gobeil2, Khawar Maqsood3, Ali Haider4, Amir Mohani2, Gregory Giugliano4, Amir S Lotfi4. 1. Department of Interventional Cardiology, The Heart Hospital - Baylor Plano Baylor Scott & White, 1100 Allied Dr, Plano, TX 75093, United States of America. Electronic address: karim.alazizi@gmail.com. 2. Baystate Medical Center, University of Massachusetts Medical School, Springfield, MA, United States of America. 3. Baystate Medical Center, University of Massachusetts Medical School, Springfield, MA, United States of America; Holyoke Medical Center, MA, United States of America. 4. Baystate Medical Center, University of Massachusetts Medical School, Springfield, MA, United States of America; Tufts University School of Medicine, MA, United States of America.
Abstract
BACKGROUND: The radial artery is the access of choice in many catheterization labs around the world due to its proven benefits over the femoral artery access. There has been growing interest in the left radial artery. We sought to evaluate the feasibility, safety and complication rates of the left distal radial artery (ldTRA) access for cardiac catheterization. METHODS: This is a single arm retrospective study evaluating the feasibility and safety of performing cardiac catheterization through ldTRA. The procedure was completed using standard diagnostic and guiding catheters. Hemostasis was achieved with a radial band. Feasibility was the ability to cannulate the distal left radial artery as well as completing the procedure without requiring an additional arterial access. The safety point included hematoma, bleeding or neuropathy. RESULTS: ldTRA was attempted in 61 patients. 59 patients had successful completion of the procedure through ldTRA. Conversion occurred in 1 patient (1.7%), requiring an additional arterial access to complete the procedure. 34 patients (55.7%) required percutaneous coronary intervention (PCI). There was no access site bleeds post procedure, no hematomas, with 100% successful hemostasis with a radial hemostatic band. There were 2 cases requiring reaccess of the distal left radial artery access for repeat revascularization, with procedure success and good left radial artery patency. CONCLUSION: ldTRA is a safe and feasible arterial access in a radial experienced catheterization lab. ldTRA provides improved operator ergonomics and patient's comfort, in addition to the advantage of being able to cannulate the bypass grafts and with a very low risk of vascular complications.
BACKGROUND: The radial artery is the access of choice in many catheterization labs around the world due to its proven benefits over the femoral artery access. There has been growing interest in the left radial artery. We sought to evaluate the feasibility, safety and complication rates of the left distal radial artery (ldTRA) access for cardiac catheterization. METHODS: This is a single arm retrospective study evaluating the feasibility and safety of performing cardiac catheterization through ldTRA. The procedure was completed using standard diagnostic and guiding catheters. Hemostasis was achieved with a radial band. Feasibility was the ability to cannulate the distal left radial artery as well as completing the procedure without requiring an additional arterial access. The safety point included hematoma, bleeding or neuropathy. RESULTS: ldTRA was attempted in 61 patients. 59 patients had successful completion of the procedure through ldTRA. Conversion occurred in 1 patient (1.7%), requiring an additional arterial access to complete the procedure. 34 patients (55.7%) required percutaneous coronary intervention (PCI). There was no access site bleeds post procedure, no hematomas, with 100% successful hemostasis with a radial hemostatic band. There were 2 cases requiring reaccess of the distal left radial artery access for repeat revascularization, with procedure success and good left radial artery patency. CONCLUSION: ldTRA is a safe and feasible arterial access in a radial experienced catheterization lab. ldTRA provides improved operator ergonomics and patient's comfort, in addition to the advantage of being able to cannulate the bypass grafts and with a very low risk of vascular complications.
Authors: Adib Koury; Lucas Moretti Monsignore; Luis Henrique de Castro-Afonso; Daniel Giansante Abud Journal: Diagn Interv Radiol Date: 2020-11 Impact factor: 2.630