Feasibility and applicability of coronary stent implantation with the direct brachial approach: Results of a single-center study

Nolan, James; Batin, Phillip D; Welsh, Colin; Lindsay, Steven; McLenachan, James M.; Cowan, Campbell; Perrins, John

doi:10.1016/s0002-8703(97)80018-x

Cited by 7 publications

(7 citation statements)

References 14 publications

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“…Failure to access the brachial artery using the percutaneous [4,9] or cut down [10] technique is less common. This discrepancy may be explained in part by the small caliber of the radial artery.…”

Section: Introductionmentioning

confidence: 99%

Failure of transradial approach during coronary interventions: Anatomic considerations

Valsecchi¹,

Vassileva²,

Musumeci³

et al. 2006

Cathet Cardio Intervent

188

144

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The anatomy of the radial artery has yet to be systematically studied from the perspective of using it as a route for catheter access. We prospectively performed angiography of the arteries of the upper limb to delineate the anatomic features of the radial artery as a way to determine the feasibility of using it as a route for coronary intervention. We studied 2,211 consecutive patients submitted to transradial cardiac catheterization. In all patients, an angiography of the upper limb arteries was performed before and after procedure. Radial puncture was successful in 98.9% of patients. At angiography, anatomic variations of upper limb arteries were noted in 505 patients (22.8%) and included tortuous configurations (3.8%), stenosis (1.7%), hypoplasias (7.7%), radioulnar loop (0.8%), abnormal origin of the radial artery (8.3%), and lusoria subclavian artery (0.45%). Overall procedural success by transradial approach was 97.5%. Patients with anatomic variations of radial artery had a significantly lower puncture (96.2% vs 99.7%, P < 0.0001) and procedural (93.1% vs 98.8%, P < 0.0001) success. The procedure was successfully performed by radial approach in 98.8% of patients with tortuous configurations, 91.9% of radial stenosis, 93.9% of hypoplastic radial artery, 83.3% of radioulnar loop, 96.7% of radial axillary origin, and 60% of lusoria subclavian artery setting. Anatomic variations of the radial artery are not rare. However, they do not represent an important limitation in transradial approach if they are well documented previously.

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Section: Introductionmentioning

confidence: 99%

Failure of transradial approach during coronary interventions: Anatomic considerations

Valsecchi¹,

Vassileva²,

Musumeci³

et al. 2006

Cathet Cardio Intervent

188

144

View full text Add to dashboard Cite

show abstract

“…Failure to access the brachial artery using the percutaneous [4,9] or cutdown [10] technique is less common. This discrepancy may be explained in part by the small caliber of the radial artery.…”

Section: Introductionmentioning

confidence: 99%

Anatomic variations of the radial artery in patients undergoing transradial coronary intervention

Yokoyama

Takeshita

Ochiai

et al. 2000

Cathet. Cardiovasc. Intervent.

145

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“…Kiemeneij et al [3] have reported that the success rate for cannulation by the brachial and radial approaches is 95.7% and 93.0%, respectively, the success rate of the radial approach being lower than the femoral [7]. There is also the further consideration, reported by Nolan et al [4], that 5% of patients treated by the radial approach suffer radial artery spasm. In any case, we saw no incidence of spasm among our brachial subjects.…”

Section: Discussionmentioning

confidence: 98%

“…Nolan et al [4] have reported that the incidence of acute coronary occlusion for 10,000 IU of heparin during stenting was 1.4% by the femoral approach and 2.7% by the brachial artery. In the present study, we not only saw lower rates of acute thrombotic occlusion with lower-dose heparin, but the figure for both femoral and brachial approach subjects was 0.9%, suggesting that there is no increased risk of occlusion with lower-dose heparin.…”

Section: Discussionmentioning

confidence: 99%

Efficacy and safety of PTCA using brachial approach and low‐dose heparin

Taguchi

Kawarabayashi

Tanaka

et al. 2001

Cathet Cardio Intervent

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Percutaneous transluminal coronary angioplasty (PTCA) is routinely performed using the femoral approach. However, recent reports suggest the usefulness of the brachial approaches for patients for whom the femoral approach is impossible due to peripheral vessel disease or to shortened postoperative rest times. However, some reports have revealed that the incidence of vascular complications undergoing brachial-approach PTCA may be higher than those with the femoral approach, possibly due to relatively higher dose of heparin. Accordingly, in this study we evaluated the efficacy and safety of PTCA using the brachial approach and low-dose heparin, hypothesizing that lowering the heparin dose might result in reduced vascular complications. The study population of patients admitted for angina pectoris consisted of 217 subjects (221 lesions) who underwent brachial-approach PTCA and 102 subjects (115 lesions) who underwent PTCA via the femoral approach. Both groups were monitored for complications. There were no significant differences in patient or lesion characteristics between the groups. Incidence of vascular complications tended to be lower in the brachial group than in the femoral group (1.8% vs. 3.5%), although the difference did not reach statistical significance. Use of anodynes was also significantly lower in the brachial group (3.6% vs. 33%). PTCA from the brachial approach with low-dose heparin is as safe and effective a strategy as compared with the femoral approach with standard dose of heparin.

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Feasibility and applicability of coronary stent implantation with the direct brachial approach: Results of a single-center study

Cited by 7 publications

References 14 publications

Failure of transradial approach during coronary interventions: Anatomic considerations

Failure of transradial approach during coronary interventions: Anatomic considerations

Anatomic variations of the radial artery in patients undergoing transradial coronary intervention

Efficacy and safety of PTCA using brachial approach and low‐dose heparin

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