Radial catheterization pitfalls: Difference between revisions
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The data that had been published up till now entails an incidence of about 2% to 34% of Radial artery Spasm, which would result in transfemoral approach being used instead. <ref name="pmid24732918">{{cite journal| author=Hizoh I, Majoros Z, Major L, Gulyas Z, Szabo G, Kerecsen G et al.| title=Need for prophylactic application of verapamil in transradial coronary procedures: a randomized trial. The VITRIOL (is Verapamil In TransRadial Interventions OmittabLe?) trial. | journal=J Am Heart Assoc | year= 2014 | volume= 3 | issue= 2 | pages= e000588 | pmid=24732918 | doi=10.1161/JAHA.113.000588 | pmc= | url=http://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=24732918 }} </ref> | The data that had been published up till now entails an incidence of about 2% to 34% of Radial artery Spasm, which would result in transfemoral approach being used instead. <ref name="pmid24732918">{{cite journal| author=Hizoh I, Majoros Z, Major L, Gulyas Z, Szabo G, Kerecsen G et al.| title=Need for prophylactic application of verapamil in transradial coronary procedures: a randomized trial. The VITRIOL (is Verapamil In TransRadial Interventions OmittabLe?) trial. | journal=J Am Heart Assoc | year= 2014 | volume= 3 | issue= 2 | pages= e000588 | pmid=24732918 | doi=10.1161/JAHA.113.000588 | pmc= | url=http://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=24732918 }} </ref> | ||
So some precautions should be made beforehand in anticipation for some of these complications. | |||
==Potential Pitfalls of the Radial Approach to Cardiac Catheterization== | ==Potential Pitfalls of the Radial Approach to Cardiac Catheterization== | ||
Revision as of 22:04, 21 August 2014
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Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1]
Overview
The data that had been published up till now entails an incidence of about 2% to 34% of Radial artery Spasm, which would result in transfemoral approach being used instead. [1] So some precautions should be made beforehand in anticipation for some of these complications.
Potential Pitfalls of the Radial Approach to Cardiac Catheterization
- Spasm
- Vessel tortuosity
- Guide catheter support and selection may be reduced
- Loss of radial artery pulse in 4% of cases
- Potential increase in the duration of the procedure and fluroscopy time
- The radial artery has been instrumented should there be a desire to use it as a conduit for CABG
- It is the second and not the first approach learned by trainees
- There is a learning curve in treating spasm, navigating anatomy, and manipulating catheters
- Anatomically there can be a loop in the artery near the brachial in about 10% of cases
- Smaller sheaths are required (4-8F)
References
- ↑ Hizoh I, Majoros Z, Major L, Gulyas Z, Szabo G, Kerecsen G; et al. (2014). "Need for prophylactic application of verapamil in transradial coronary procedures: a randomized trial. The VITRIOL (is Verapamil In TransRadial Interventions OmittabLe?) trial". J Am Heart Assoc. 3 (2): e000588. doi:10.1161/JAHA.113.000588. PMID 24732918.