Percutaneous brachial approach using the femoral artery sheath for left heart catheterization and selective coronary angiography

Maouad, J; Hébert, Jean-Louis; Fernandez, Francis Charles L.; Gay, J.G.

doi:10.1002/ccd.1810110514

Cited by 19 publications

(10 citation statements)

References 7 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…This is more important if we keep in mind that this route is used in many laboratories as an alternative approach only when the femoral route is not available and thus the lack of experience does increase arterial morbidity. The percutaneous entry of the right brachial artery using a 7F or 8F sheath has been shown to be a safe and reliable alternative to cut-down and offers several advantages [7-9, 13 -1 51, despite the fact that its incidence of arterial morbidity is similar to that with the Sones technique [8,9,13,15] and that some authors [9] do not advise the use of this technique in thin people. The introduction of catheters with a smaller diameter allows the utilization of this route using the percutaneous puncture technique with a hypothetical reduction of arterial morbidity [ 131.…”

Section: Discussionmentioning

confidence: 99%

“…In group I the technique used was quite similar to that described by Fergusson and Kamada [7] although using a sheath with a valve and side arm, as others had done [8,9]: the brachial artery was palpated at the elbow crease and the overlying skin and subcutaneous tissue infiltrated with Mevipacain HCI . During careful palpation of the artery an 18-gauge abbocath needle was inserted at an angle of about 45" to the skin surface so as to transfix the vessel, and the needle was withdrawn.…”

Section: Methodsmentioning

confidence: 98%

See 1 more Smart Citation

Percutaneous right brachial artery approach with 5f catheters for studying coronary artery disease

Lupon-Rosés

Domingo

Ángel

et al. 1991

Cathet. Cardiovasc. Diagn.

View full text Add to dashboard Cite

We prospectively studied 60 ischemic patients with 5F catheters (Pigtail and Amplatz) using the percutaneous right brachial artery approach (group I), in order to compare this technique with two groups of 100 patients each randomly studied by the femoral route with either 5F (group II) or 8F (group III) catheters (Pigtail and Judkins). The following parameters were analyzed: need to change the initially elected catheter diameter or/and artery approach; technical difficulty for obtaining LV, LCA, and RCA angiograms; total time of X-ray exposure; quality image of LV, LCA, and RCA angiograms; incidence of arterial puncture related hematomas or total arterial occlusion; and duration of local compression after sheath removal. There were no differences between 5F brachial and femoral approaches except for the arterial compression time (p less than 0.01) and the X-ray exposure time (p = 0.03) which were longer with the brachial approach. Whatever the route used, 5F showed a mild increase difficulty (brachial p = 0.001; femoral p = 0.01) and a mild decreased quality image for LCA (branchial p = 0.006; femoral p less than 0.05). Mild hematomas were more frequent with 8F catheters (p less than 0.05). The procedure could be completed by the elected first artery and type of catheter (5F or 8F) in 57/60 patients in group I, in 95/100 in group II, and in 96/100 in group III (nonsignificant differences). Thus, the percutaneous right brachial artery approach using 5F catheters is similar to the femoral artery approach with the same catheters. Although both of them showed a mild increased technical difficulty and a mild decreased quality image compared to 8F, mainly for LCA angiograms, they allowed complete and reliable angiograms reading and analysis.

show abstract

Section: Discussionmentioning

confidence: 99%

Section: Methodsmentioning

confidence: 98%

Percutaneous right brachial artery approach with 5f catheters for studying coronary artery disease

Lupon-Rosés

Domingo

Ángel

et al. 1991

Cathet. Cardiovasc. Diagn.

View full text Add to dashboard Cite

show abstract

“…No other series of such volume exists, though there are a number of moderate-volume studies also suggesting that the percutaneous brachial approach can be a useful technique [11][12][13][14][15].…”

Section: Discussionmentioning

confidence: 99%

Occasional‐operator percutaneous brachial coronary angiography: First, do no arm

Hildick‐Smith

Khan

Shapiro

et al. 2002

Cathet Cardio Intervent

View full text Add to dashboard Cite

The percutaneous brachial approach to coronary angiography is perceived, rightly or wrongly, to be the easiest of the arm approaches. Predominantly femoral operators may therefore be encouraged to use the percutaneous brachial approach as an occasional procedure. We decided to investigate prospectively whether this was a reasonable strategy by examining outcome in patients who underwent percutaneous brachial cardiac catheterization by occasional brachial operators. Between October 1997 and 2000, 55 patients underwent percutaneous brachial coronary angiography (0.6% of coronary angiographies), aged 66 +/- 10 years, of whom 40 (73%) were male. Chief indications for a brachial approach were peripheral vascular disease in 35 (64%), failed femoral approach in 10 (18%), and orthopnoea in 5 (9%). The procedure was completed successfully in 46 patients (84%). Reasons for failure were failure of access (two), brachial artery spasm (one), inability to negotiate brachial/subclavian tortuosity (two), dissection of the brachial artery (two), and inability to intubate a vein graft (two). Six patients required catheterization from an alternative site (brachial arteriotomy in two, percutaneous transradial in two, femoral in two), with success in all. There were complications of varying severity in 20 patients (36%). Major complications were false aneurysm requiring surgical repair (one), large brachial hematoma requiring surgical exploration and arterial repair (one), and hematoma with clinical median nerve dysfunction for one month. Minor complications included need for repeat coronary angiography via alternative approach (six), weakness of radial pulse < 24 hr (two), brachial artery dissection without clinical sequelae (two), brachial artery spasm terminating procedure (one), and wound oozing (three). Percutaneous brachial coronary angiography is a hazardous procedure when undertaken by occasional brachial operators. Complications are unacceptably frequent. As with all practical procedures, complication rates are likely to be inversely proportional to operator volumes. Patients requiring an arm approach should be referred to operators with high-volume brachial or radial experience.

show abstract

“…The protocol was the same as for catheterization [2]: An intravenous infusion of vasodilator and spasmolytic drug (400 mg of Naftidrofuryl oxalate [Praxilene] in 250 cc of 5% dextrose solution at a rate of 2 cc/min) was started 15 min before the procedure and continued 1 h after the withdrawal of the sheath. Heparin was given by an IV bolus of 10,000 I.U.…”

Section: Techniquementioning

confidence: 99%

“…After our experience with the percutaneous technique from the arm for left heart catheterization, using 8F desilets sheaths, we conclude that this is a method with a low percentage of complications when spasm of the brachial artery is prevented by following a standardized protocol [2].…”

Section: Introductionmentioning

confidence: 97%

Percutaneous brachial approach for transluminal coronary angioplasty

Maouad

Hébert

Guermonprez

1989

Cathet. Cardiovasc. Diagn.

View full text Add to dashboard Cite

Transluminal coronary angioplasty from the arm is performed generally with cutdown and brachial arteriotomy. We describe a brachial percutaneous technique for coronary angioplasty, almost similar to the femoral one, with a special focus on the prevention of induced vasoconstriction. Our preliminary results are satisfactory and without complications: 13 procedures in 11 patients have been performed over a 30 month period, with the sheaths left in place for 4-6 h after the procedure. This method could be an easy alternative to the Sones technique for operators who are essentially familiar with the femoral percutaneous arterial approach.

show abstract

Percutaneous brachial approach using the femoral artery sheath for left heart catheterization and selective coronary angiography

Cited by 19 publications

References 7 publications

Percutaneous right brachial artery approach with 5f catheters for studying coronary artery disease

Percutaneous right brachial artery approach with 5f catheters for studying coronary artery disease

Occasional‐operator percutaneous brachial coronary angiography: First, do no arm

Percutaneous brachial approach for transluminal coronary angioplasty

Contact Info

Product

Resources

About