Radial catheterization pitfalls: Difference between revisions
Jump to navigation
Jump to search
| Line 11: | Line 11: | ||
==Potential Pitfalls of the Radial Approach to Cardiac Catheterization== | ==Potential Pitfalls of the Radial Approach to Cardiac Catheterization== | ||
# Spasm | # Spasm | ||
# Vessel tortuosity | # Vessel tortuosity. Some of the tortuous forms are:- | ||
** Alpha shape radial artery. | |||
** S-shaped radial artery. | |||
** Proximal and distal omega shaped radial artery. | |||
** Brachial alpha loop. | |||
** High origin radial artery | |||
# Guide catheter support and selection may be reduced | # Guide catheter support and selection may be reduced | ||
# Loss of [[radial artery]] pulse in 4% of cases | # Loss of [[radial artery]] pulse in 4% of cases | ||
Revision as of 01:17, 22 August 2014
|
Radial artery catheterization Microchapters |
|
Case Studies |
|---|
|
Radial catheterization pitfalls On the Web |
|
American Roentgen Ray Society Images of Radial catheterization pitfalls |
|
Directions to Hospitals Treating Radial artery cathetarization |
|
Risk calculators and risk factors for Radial catheterization pitfalls |
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 of such complications.
Potential Pitfalls of the Radial Approach to Cardiac Catheterization
- Spasm
- Vessel tortuosity. Some of the tortuous forms are:-
- Alpha shape radial artery.
- S-shaped radial artery.
- Proximal and distal omega shaped radial artery.
- Brachial alpha loop.
- High origin radial artery
- 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.