Radial approach to right heart catheterization: Early experience with a promising technique

Abstract

Transradial cardiac catheterization has been historically limited to arterial catheterization. Using small-diameter introducers and catheters, a technique of combined right and left heart catheterization is described using both the radial artery and its neighboring vein. Evaluation of 55 sequential right and left heart procedures showed that it could be accomplished in > 50% using venous access in the forearm. This approach has many potential advantages, although the ability to access routinely both venous and arterial vessels at the level of the wrist is unclear.

Transradial arterial access for coronary and peripheral procedures: Executive summary by the transradial committee of the SCAI

“…Reports outlining the concurrent use of both arterial and venous access via the arm surfaced in the last decade from several different groups [109–111] with subsequent reports suggesting that this approach may be more efficient than the traditional groin approach [112, 113].…”

Segurança e eficácia da cateterização cardíaca direita e esquerda pelo acesso transradial comparado ao transfemoral: experiência inicial

“…Uma limitação do uso dessa técnica tem sido a percepção de que a cateterização simultânea direita e esquerda não pode ser realizada sem o uso de um acesso secundário, como as veias centrais do pescoço, ou de um acesso femoral. Entretanto, estudos prévios demonstraram que a TTR pode ser utilizada em combinação com a de um acesso venoso no antebraço com excelentes resultados e aumento da segurança para o paciente 1,2 . O objetivo deste estudo foi comparar os resultados obtidos com a TTR em combinação com a cateterização direita com a téc-nica transfemoral (TTF), em pacientes com indicação de realização de cateterismo cardíaco direito e esquerdo.…”

Feasibility and procedure-related patient discomfort of peripheral venous access for coronary sinus cannulation during electrophysiology procedures

“…Peripheral venous access has been proposed in the past as a route for right heart access, mainly for diagnostic right heart catheterization [1]. However, it has not become mainstay, either for the purpose of right heart hemodynamic assessment, or for other applications, although it may offer significant advantages compared to central venous access, including virtual elimination of the probability of lung puncture and pneumothorax or trauma of a major artery.…”