Antecubital vs Femoral Venous Access for Right Heart Catheterization: Benefits of a Flashback

Roule, Vincent; Ailem, Sabri; Legallois, Damien; Dahdouh, Ziad; Lognoné, Thérèse; Grollier, Gilles; Milliez, Paul; Sabatier, Rémi; Beygui, Farzin

doi:10.1016/j.cjca.2015.04.026

Cited by 20 publications

(22 citation statements)

References 12 publications

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“…No patients presented with symptomatic access-site thrombosis. In another study, comparing antecubital vs. femoral venous access for right heart catheterization, Roule et al (8) found fewer access-site hematomas after antecubital vein puncture.…”

Section: Discussionmentioning

confidence: 99%

Brachial Approach As an Alternative Technique of Fibrin Sheath Removal for Implanted Venous Access Devices

et al. 2017

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Implanted venous access device (IVAD) late dysfunction is commonly caused by fibrin sheath formation. The standard method of endovascular fibrin sheath removal is performed via the femoral vein. However, it is not always technically feasible and sometimes contraindicated. Moreover, approximately 4–6 h of bed rest is necessary after the procedure. In this article, we describe an alternative method of fibrin sheath removal using the brachial vein approach in a young woman receiving chemotherapy for breast cancer. The right basilic vein was punctured, and a long 6°F introducer sheath was advanced into the right subclavian vein. Endovascular maneuvers consisted on advancing Atrieve™ Vascular Snare 15–9 mm after catheter insertion in the superior vena cava through a 5.2°F Judkins left catheter. IVAD patency was restored without any complication, and the patient was discharged immediately after the procedure. In conclusion, fibrin sheath removal from an obstructed IVAD could be performed via the right brachial vein. Further research is necessary in order to prove efficacy of this technique.

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Section: Discussionmentioning

confidence: 99%

Brachial Approach As an Alternative Technique of Fibrin Sheath Removal for Implanted Venous Access Devices

et al. 2017

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“…RHC has a vital role in the diagnosis, management and follow-up of patients with PH. Despite the recently increased use of AVA-RHC, [8][9][10] the majority continue to be performed via the more ''traditional'' proximal locations. This study demonstrates that RHC by AVA can be performed safely, efficiently and accurately by a pulmonologist in the subpopulation of patients with PH.…”

Section: Discussionmentioning

confidence: 99%

“…RHC via an AVA has gained increased popularity over the traditional approach in cardiology literature due to its improved safety profile and comparable success rates. [7][8][9] However, direct comparison between the two procedures in patients with PH is lacking. Additionally, there is insufficient data in the literature comparing procedural duration, fluoroscopy time and radiation dose between the two approaches.…”

Section: Introductionmentioning

confidence: 99%

Feasibility and safety of the antecubital venous access for right heart catheterization in patients with pulmonary hypertension

et al. 2020

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Background The diagnosis of pulmonary arterial hypertension requires right heart catheterization (RHC) which is typically performed via proximal venous access (PVA). Antecubital venous access (AVA) is an alternative approach for RHC that can minimize complications, decrease procedural duration and allow for immediate patient recovery. A direct comparison between the two procedures in patients with pulmonary hypertension (PH) is lacking. Objectives To determine the feasibility, safety, and adoption rates of AVA-RHC as compared with ultrasound-guided PVA in a subpopulation of patients with PH. Methods All patients who underwent RHC for evaluation of PH between December 2014 and March 2017 at a single large academic medical center were included in this study. Demographic, procedural and outcomes data were retrieved from the medical records. Results In total, 159 RHC were included (124 AVA, 35 PVA). The duration of RHC was significantly shorter in the AVA compared with PVA group (53 (IQR 38–70) vs. 80 (IQR 56–95) min, respectively, p < 0.001). 19% of AVA (24/124) procedures were switched to PVA. Failed attempts at AVA were more common in scleroderma (50% failure rate). Success rate of AVA increased from 81.2% to 93.3% from the first to last quartile. Fluoroscopy time was similar in both groups, the difference between the groups in the radiation dose are not statistically significant (54.5 (IQR 25–110) vs. 84.5 (IQR 30–134)). Conclusion AVA-RHC is a feasible and safe alternative to PVA in patients with PH who are evaluated for pulmonary arterial hypertension diagnosis. Our experience and rapid adoption rate support the use of AVA as the preferred access site for RHC in uncomplicated PH patients.

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“…Since Werner Forssman performed the first human cardiac catheterisation accessing his own right heart through a left antecubital vein, in 1929,1 the field has evolved tremendously and right heart catheterisation has become an important and frequently performed procedure in a wide range of medical conditions 2. Currently, the femoral or internal jugular veins are the most frequently accessed sites used for the performance of right heart catheterisations and,2 as a parallel to radial approach for left heart catheterisation,3–5 forearm veins have recently become a new potential route for the performance of right heart catheterisations 6…”

Section: Introductionmentioning

confidence: 99%

“…The data supporting the utilisation of the antecubital venous approach for right heart catheterisation are mainly derived from a series in which eligibility for such approach was based on visualisation/palpation of the antecubital veins 6–15. Hence, the applicability of the antecubital venous approach for the highly heterogeneous populations usually referred for right heart catheterisation is unclear.…”

Section: Introductionmentioning

confidence: 99%

Ultrasound-guided antecubital vein approach for right heart catheterisation in a Brazilian tertiary centre

et al. 2020

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ObjectiveAs a parallel to the radial approach for left heart catheterisation, forearm veins may be considered for the performance of right heart catheterisation. However, data regarding the application of this technique under ultrasound guidance are scarce. The current study aims to demonstrate the feasibility of right heart catheterisation through ultrasound-guided antecubital venous approach in the highly heterogeneous population usually referred for right heart catheterisation.MethodsData from consecutive right heart catheterisations performed at an academic centre in Brazil, between January 2016 and March 2017 were prospectively collected.ResultsAmong 152 performed right heart catheterisations, ultrasound-guided antecubital venous approach was attempted in 127 (84%) cases and it was made feasible in 92.1% of those. Yet, there was no immediate vascular complication with the antecubital venous approach in this prospective series.ConclusionsUltrasound-guided antecubital venous approach for the performance of right heart catheterisation was feasible in the vast majority of cases in our study, without occurrence of vascular complications.

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Antecubital vs Femoral Venous Access for Right Heart Catheterization: Benefits of a Flashback

Cited by 20 publications

References 12 publications

Brachial Approach As an Alternative Technique of Fibrin Sheath Removal for Implanted Venous Access Devices

Brachial Approach As an Alternative Technique of Fibrin Sheath Removal for Implanted Venous Access Devices

Feasibility and safety of the antecubital venous access for right heart catheterization in patients with pulmonary hypertension

Ultrasound-guided antecubital vein approach for right heart catheterisation in a Brazilian tertiary centre

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