Radial artery cathetarization overview: Difference between revisions

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==Overview==
==Overview==
Following the introduction of radial percutaneous coronary intervention (r-PCI) in 1989 by Canadian Cardiologist, Lucian Campeau,<ref name="Campeau-1989">{{Cite journal  | last1 = Campeau | first1 = L. | title = Percutaneous radial artery approach for coronary angiography. | journal = Cathet Cardiovasc Diagn | volume = 16 | issue = 1 | pages = 3-7 | month = Jan | year = 1989 | doi =  | PMID = 2912567 }}</ref> there have been a gradual increase in its preference over the femoral approach internationally;<ref name="Hamon-2013">{{Cite journal  | last1 = Hamon | first1 = M. | last2 = Pristipino | first2 = C. | last3 = Di Mario | first3 = C. | last4 = Nolan | first4 = J. | last5 = Ludwig | first5 = J. | last6 = Tubaro | first6 = M. | last7 = Sabate | first7 = M. | last8 = Mauri-Ferré | first8 = J. | last9 = Huber | first9 = K. | title = Consensus document on the radial approach in percutaneous cardiovascular interventions: position paper by the European Association of Percutaneous Cardiovascular Interventions and Working Groups on Acute Cardiac Care** and Thrombosis of the European Society of Cardiology. | journal = EuroIntervention | volume = 8 | issue = 11 | pages = 1242-51 | month = Mar | year = 2013 | doi = 10.4244/EIJV8I11A192 | PMID = 23354100 }}</ref> with United States experiencing a 10-fold increase (1 in every 6 PCIs performed) in the adoption of transradial procedures between 2007 and 2012,<ref name="Feldman-2013">{{Cite journal  | last1 = Feldman | first1 = DN. | last2 = Swaminathan | first2 = RV. | last3 = Kaltenbach | first3 = LA. | last4 = Baklanov | first4 = DV. |last5 = Kim | first5 = LK. | last6 = Wong | first6 = SC. | last7 = Minutello | first7 = RM. | last8 = Messenger | first8 = JC. | last9 = Moussa | first9 = I. |title = Adoption of radial access and comparison of outcomes to femoral access in percutaneous coronary intervention: an updated report from the national cardiovascular data registry (2007-2012). | journal = Circulation | volume = 127 | issue = 23 | pages = 2295-306 | month = Jun | year = 2013 | doi = 10.1161/CIRCULATIONAHA.112.000536 | PMID = 23753843 }}</ref> largely as a result of reduced major bleeding, vascular complications, length of hospital stay and cost, and increased patient satisfaction and quality of care.
The first introduction to the use of radial artery for cardiac catheterization was made by Radner in 1948.<ref name="RADNER-1948">{{Cite journal  | last1 = RADNER | first1 = S. | title = Thoracal aortography by catheterization from the radial artery; preliminary report of a new technique. | journal = Acta radiol | volume = 29 | issue = 2 | pages = 178-80 | month = Feb | year = 1948 | doi =  | PMID = 18908938 }}</ref>
Subsequently, a Canadian Cardiologist, Lucian Campeau, in 1989 re-introduced the practice.<ref name="Campeau-1989">{{Cite journal  | last1 = Campeau | first1 = L. | title = Percutaneous radial artery approach for coronary angiography. | journal = Cathet Cardiovasc Diagn | volume = 16 | issue = 1 | pages = 3-7 | month = Jan | year = 1989 | doi =  | PMID = 2912567 }}</ref> There have been a gradual increase in its preference over the femoral approach internationally;<ref name="Hamon-2013">{{Cite journal  | last1 = Hamon | first1 = M. | last2 = Pristipino | first2 = C. | last3 = Di Mario | first3 = C. | last4 = Nolan | first4 = J. | last5 = Ludwig | first5 = J. | last6 = Tubaro | first6 = M. | last7 = Sabate | first7 = M. | last8 = Mauri-Ferré | first8 = J. | last9 = Huber | first9 = K. | title = Consensus document on the radial approach in percutaneous cardiovascular interventions: position paper by the European Association of Percutaneous Cardiovascular Interventions and Working Groups on Acute Cardiac Care** and Thrombosis of the European Society of Cardiology. | journal = EuroIntervention | volume = 8 | issue = 11 | pages = 1242-51 | month = Mar | year = 2013 | doi = 10.4244/EIJV8I11A192 | PMID = 23354100 }}</ref> with United States experiencing a 10-fold increase (1 in every 6 PCIs performed) in the adoption of transradial procedures between 2007 and 2012,<ref name="Feldman-2013">{{Cite journal  | last1 = Feldman | first1 = DN. | last2 = Swaminathan | first2 = RV. | last3 = Kaltenbach | first3 = LA. | last4 = Baklanov | first4 = DV. |last5 = Kim | first5 = LK. | last6 = Wong | first6 = SC. | last7 = Minutello | first7 = RM. | last8 = Messenger | first8 = JC. | last9 = Moussa | first9 = I. |title = Adoption of radial access and comparison of outcomes to femoral access in percutaneous coronary intervention: an updated report from the national cardiovascular data registry (2007-2012). | journal = Circulation | volume = 127 | issue = 23 | pages = 2295-306 | month = Jun | year = 2013 | doi = 10.1161/CIRCULATIONAHA.112.000536 | PMID = 23753843 }}</ref> largely as a result of reduced major bleeding, vascular complications, length of hospital stay and cost, and increased patient satisfaction and quality of care.
The rationale for the choice of radial access include:
The rationale for the choice of radial access include:
* Decreased risk of limb ischemia - The hand has a dual arterial supply i.e., radial and ulnar arteries, which unites to form the superficial and deep palmer arches.  Therefore, the radial artery is not an end artery like the femoral artery, thus decreasing the risk of arterial occlusion post PCI.
* Decreased risk of limb ischemia - The hand has a dual arterial supply i.e., radial and ulnar arteries, which unites to form the superficial and deep palmer arches.  Therefore, the radial artery is not an end artery like the femoral artery, thus decreasing the risk of arterial occlusion post PCI.

Latest revision as of 19:13, 27 November 2013

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Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1]; Associate Editor(s)-in-Chief: Ayokunle Olubaniyi, M.B,B.S [2]

Overview

The first introduction to the use of radial artery for cardiac catheterization was made by Radner in 1948.[1] Subsequently, a Canadian Cardiologist, Lucian Campeau, in 1989 re-introduced the practice.[2] There have been a gradual increase in its preference over the femoral approach internationally;[3] with United States experiencing a 10-fold increase (1 in every 6 PCIs performed) in the adoption of transradial procedures between 2007 and 2012,[4] largely as a result of reduced major bleeding, vascular complications, length of hospital stay and cost, and increased patient satisfaction and quality of care. The rationale for the choice of radial access include:

  • Decreased risk of limb ischemia - The hand has a dual arterial supply i.e., radial and ulnar arteries, which unites to form the superficial and deep palmer arches. Therefore, the radial artery is not an end artery like the femoral artery, thus decreasing the risk of arterial occlusion post PCI.
  • Decreased risk of bleeding - The superficial course of the distal radial artery allows for easy compressibility in order to minimize hemorrhage post PCI.

References

  1. RADNER, S. (1948). "Thoracal aortography by catheterization from the radial artery; preliminary report of a new technique". Acta radiol. 29 (2): 178–80. PMID 18908938. Unknown parameter |month= ignored (help)
  2. Campeau, L. (1989). "Percutaneous radial artery approach for coronary angiography". Cathet Cardiovasc Diagn. 16 (1): 3–7. PMID 2912567. Unknown parameter |month= ignored (help)
  3. Hamon, M.; Pristipino, C.; Di Mario, C.; Nolan, J.; Ludwig, J.; Tubaro, M.; Sabate, M.; Mauri-Ferré, J.; Huber, K. (2013). "Consensus document on the radial approach in percutaneous cardiovascular interventions: position paper by the European Association of Percutaneous Cardiovascular Interventions and Working Groups on Acute Cardiac Care** and Thrombosis of the European Society of Cardiology". EuroIntervention. 8 (11): 1242–51. doi:10.4244/EIJV8I11A192. PMID 23354100. Unknown parameter |month= ignored (help)
  4. Feldman, DN.; Swaminathan, RV.; Kaltenbach, LA.; Baklanov, DV.; Kim, LK.; Wong, SC.; Minutello, RM.; Messenger, JC.; Moussa, I. (2013). "Adoption of radial access and comparison of outcomes to femoral access in percutaneous coronary intervention: an updated report from the national cardiovascular data registry (2007-2012)". Circulation. 127 (23): 2295–306. doi:10.1161/CIRCULATIONAHA.112.000536. PMID 23753843. Unknown parameter |month= ignored (help)


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