Percutaneous brachial artery catheterization

Fergusson, David J. G.; Kamada, Roy O.

doi:10.1080/00325481.1986.11699533

Cited by 2 publications

(2 citation statements)

References 7 publications

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“…The radial approach is a quicker procedure with comparable success rates [26] that has therefore superseded the brachial cut‐down in most catheter laboratories. The percutaneous brachial approach has been championed by some operators [27], but is a procedure with a significant risk of complications [28, 29], particularly if undertaken only occasionally [30]. Axillary approaches [31, 32] have gradually gone out of favor.…”

Section: Discussionmentioning

confidence: 99%

Transradial coronary angiography in patients with contraindications to the femoral approach: An analysis of 500 cases

Hildick‐Smith

Walsh

Löwe

et al. 2003

Cathet Cardio Intervent

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The transradial approach to coronary angiography is considered by some to be a route of choice, by others to be a route that should be used only where there are relative contraindications to the femoral approach. We present the largest series to date of patients in whom transradial coronary angiography was undertaken specifically because of contraindications to the femoral approach. Since 1995, patients at this cardiothoracic center have been considered for a transradial approach to coronary angiography if there were relative contraindications to the femoral route. Data from 500 patients was prospectively collected. Patients were aged 66 +/- 9 years; 72% were male. Indications for the radial approach included peripheral vascular disease (305), therapeutic anticoagulation (77), musculoskeletal (59), and morbid obesity (32). Sixty-eight patients (14%) required a radial procedure following a failed femoral approach. Access was right radial 291 (58%), left radial 209 (42%). Eighteen operators were involved, but two operators undertook 355 (71%) of the cases. Catheter gauge was 6 Fr (n = 243; 49%), 5 Fr (219; 43%), and 4 Fr (29; 6%). The procedure was successful in 463 cases [92.6%; 88.2% for nonmajority vs. 94.4% (P < 0.05) for the two majority operators]. Success in males (93.6%) significantly exceeded that in females (90.1%; P < 0.05). In-catheter-laboratory duration was 45 +/- 17 min; fluoroscopy time, 7.5 +/- 6 min; radiation dose, 40 +/- 23 CGy. The procedure was without incident in 408 cases (82%). There were procedural difficulties in 18% of cases, including radial artery spasm (12%) and vasovagal response (5%). The incidence was higher with 6 Fr catheters (23%) than with 5/4 Fr (15%; P < 0.05). Major procedural complications occurred in three cases: brachial artery dissection in one and cardiac arrest in two. Postprocedure major vascular complications numbered three: claudicant pain on handgrip in one, ischemic index finger (with subsequent terminal phalanx amputation due to osteomyelitis) in one, and ischemic hand for 4 hr in one. Patients with contraindications to the femoral approach form a high-risk group. In these patients, transradial cardiac catheterization can be performed successfully and with a low risk of major complications. Minor adverse features remain frequent, occurring in one in five cases, though difficulties are minimized both with increasing operator experience and smaller sheath diameter.

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Section: Discussionmentioning

confidence: 99%

Transradial coronary angiography in patients with contraindications to the femoral approach: An analysis of 500 cases

Hildick‐Smith

Walsh

Löwe

et al. 2003

Cathet Cardio Intervent

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“…Other potential complications of brachial–femoral wire include dissection and thrombosis related to puncture‐site of the brachial artery or sheath‐insertion injury to the vessel wall and pseudoaneurysm formation. It has been reported that brachial site complications after cardiac diagnostic and therapeutic interventions ranges between 1–3% and 1–5%, respectively [10].…”

Section: Discussionmentioning

confidence: 99%

Thoracic aneurysm repair: Managing severe tortuosity with brachiofemoral traction

Lioupis

Medda

Inglese

2007

Cathet Cardio Intervent

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Challenging anatomy of the thoracic aorta is often encountered, and aortic tortuosity may be a major impediment to the propulsion of the stent-graft. Traction on both ends of a guidewire, with one end exiting the right upper extremity and the other end exiting the lower extremity, is an excellent option to manage thoracic aorta tortuosity. Careful application of simple guidelines may lessen associated risks and improve safety.

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Percutaneous brachial artery catheterization

Cited by 2 publications

References 7 publications

Transradial coronary angiography in patients with contraindications to the femoral approach: An analysis of 500 cases

Transradial coronary angiography in patients with contraindications to the femoral approach: An analysis of 500 cases

Thoracic aneurysm repair: Managing severe tortuosity with brachiofemoral traction

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