Radial artery catheterization
Editors-in-Chief: C. Michael Gibson, M.S., M.D.,
- Advantages of the Radial Approach to Cardiac Catheterization
- Reduced bleeding
- Early patient ambulation
- Greater patient satisfaction
- Potential Pitfalls of the Radial Approach to Cardiac Catheterization
- Spasm
- Vessel tortuosity
- Guide catheter support
- Performance of the Allen's Test Before the Procedure
- Choosing the Left or Right Side for the Radial Approach
If the internal mammary artery must be canulated, then the left radial artery should be used.
- Obtaining Radial Access
- Initial Insertion of the Catheters
To reduce spasm, 500 micrograms of diltiazem can be administered via the sidearm prior to insertion of the right and left sided catheters.
- Catheter selection
Many operators choose to start with the right coronary artery as the right sided catheter may allow for directing the wire as you make your way up around the arch. Once the wire is around the arch, it should remain there for exchanges. A JL 3.5 catheter may be used to engage the left coronary artery when catheterization is performed from the right arm.