Sheathless transulnar versus standard femoral arterial access for percutaneous coronary intervention on bifurcation lesions

Deftereos, Spyridon; Γιαννόπουλος, Γεώργιος; Tousoulis, Dimitris; Raisakis, Konstantinos; Kaoukis, Andreas; Kossyvakis, Charalambos; Panagopoulou, Vasiliki; Ntzouvara, Olga; Mavrogianni, Aggeliki; Michelakakis, Nikolaos; Toutouzas, Konstantinos; Pyrgakis, Vlasios; Bobotis, G.; Cleman, Michael; Stefanadis, Christodoulos

doi:10.1016/j.ijcard.2011.03.028

Cited by 7 publications

(4 citation statements)

References 8 publications

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“…In particular, several authors report a lower rate of arterial spasm and or occlusion facilitating the possible use of adjunctive devices ( i.e IVUS, double balloon for bifurcation treatment, distal protection devices, thrombectomy catheters, covered stent) usually limited when a standard 5 French or 6 French regular guiding catheter are used. Use of the 6.5 French or 7.5 French sheathless guide catheter system, which has an outer diameter less than 5 French sheath, as the default system in routine PCI is feasible and gives a high rate of procedural success not only via the radial but also via the ulnar artery, 12 as confirmed from our experience.…”

Section: Discussionsupporting

confidence: 65%

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Transulnar Sheathless Percutaneous Coronary Intervention during Bivalirudin Infusion in High-Risk Elderly Female with Non-ST Segment Elevation Myocardial Infarction

Summaria

Lucci

Mustilli³

2012

Heart International

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Due to the ageing population and raised life expectancy, elderly patients are increasingly referred for percutaneous coronary intervention (PCI) during acute coronary syndromes (ACS). Bleeding complications are not infrequent during ACS, occurring in 2–5% of patients with prognostic and economic consequences. In particular, periprocedural bleeding and vascular complications are associated with worse clinical outcome, prolonged hospital stay and increased short- and long-term mortality, especially in elderly patients with acute coronary syndromes. We report the case of an 83-year old female referred to our hospital because of non-ST segment elevation myocardial infarction with high bleeding risk and unsuitable radial artery undergoing tran-sulnar sheathless PCI during bivalirudin infusion. The clinical, technical, pharmacological and prognostic implications are discussed.

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Section: Discussionsupporting

confidence: 65%

“…8–11 Similar to TRA, the complications associated with the transulnar approach (TUA) increase with the size of sheath used and may theoretically be reduced by the use of a sheathless guide catheter system. 12 …”

Section: Introductionmentioning

confidence: 99%

Transulnar Sheathless Percutaneous Coronary Intervention during Bivalirudin Infusion in High-Risk Elderly Female with Non-ST Segment Elevation Myocardial Infarction

Summaria

Lucci

Mustilli³

2012

Heart International

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“…Newer cardiac imaging techniques are very promising in diagnosis and management of SCAD. [26][27][28][29] Noninvasive techniques for assessment of SCAD include Multi-detector CT (MDCT) and Dual-source computed tomography. MDCT is used to tell the details about the extent and thickness of hematoma as well as to document healing and follow up [30,31].…”

Section: Review Of the Literature And Discussionmentioning

confidence: 99%

Simultaneous Occurrence of Spontaneous Coronary Artery Dissection and Embolic Stroke

Akbar

2014

BJMMR

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Acute coronary syndrome (ACS) due to spontaneous coronary artery dissection (SCAD) is rare. Further, concurrent ACS with a cerebrovascular accident is improbable, but possible. We report a case of a young man, with a history of Hodgkin's lymphoma treated with a combination of chemotherapy and radiotherapy ten years ago, presented with acute coronary syndrome caused by an extensive dissection of the right coronary artery, together with acute ischemic stroke. Survivors of Hodgkin's lymphoma are at increased risk for cardiovascular complications due to radiation, which can expedite atherosclerosis and can, eventually, give rise to dissection and cerebrovascular disease, as exemplified in our case. This case report and review outlines the incidence, epidemiology, causes, pathophysiology, diagnosis and treatment of spontaneous coronary artery dissection. Our case report is a remainder to clinicians to be mindful of concomitant occurrence of these two conditions and highlights the significant impact the treatment of each has on the other, especially when the literature does not have clear recommendations about simultaneous management. Spontaneous coronary artery dissection with concomitant ischemic cerebrovascular stroke poses a therapeutic dilemma and requires a multi-disciplinary team to appropriately manage the patient.

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“…However, similar to TRA, the transulnar access (TUA) is associated with less vascular complications, shorter hospital stay, lesser patient discomfort , and lower mortality compared to the transfemoral access (TFA) . The TUA has been proposed as a safe alternative for cardiac catheterization access and found to be adequate for performing procedures of varying degrees of complexity .…”

Section: Introductionmentioning

confidence: 99%

Feasibility of ulnar artery for cardiac catheterization:AJmerULnarARtery (AJULAR) catheterization study

Gokhroo

Bisht

Padmanabhan

et al. 2015

Cathet Cardio Intervent

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Sheathless transulnar versus standard femoral arterial access for percutaneous coronary intervention on bifurcation lesions

Cited by 7 publications

References 8 publications

Transulnar Sheathless Percutaneous Coronary Intervention during Bivalirudin Infusion in High-Risk Elderly Female with Non-ST Segment Elevation Myocardial Infarction

Transulnar Sheathless Percutaneous Coronary Intervention during Bivalirudin Infusion in High-Risk Elderly Female with Non-ST Segment Elevation Myocardial Infarction

Simultaneous Occurrence of Spontaneous Coronary Artery Dissection and Embolic Stroke

Feasibility of ulnar artery for cardiac catheterization:AJmerULnarARtery (AJULAR) catheterization study

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