Total wrist access for angiography and interventions: Procedural success and access site crossover in a high volume transradial center

Kedev, Saško; Zafirovska, Biljana; Antov, Slobodan; Kostov, Jorgo; Spiroski, Igor; Boshev, Marjan; Vasilev, I; Jovkovski, Aleksandar; Taravari, Hajber; Kitanoski, Darko; Petkoska, Danica; Ho, Kalon K.L.

doi:10.1016/j.carrev.2017.12.009

Cited by 13 publications

(11 citation statements)

References 17 publications

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“…Our hospital is a high volume transradial center (80% of all PCI interventions in the country) and the main referral center for primary PCI and complex procedures. Transradial approach has been the default approach in our center since 2008 21 , which is in accordance with the ESC guidelines for treatment of PCI patients [22][23][24] , and most probably has contributed to the low MACCE and mortality in our results [7][8][9] .…”

Section: Discussionsupporting

confidence: 70%

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Risk Factor Distribution and Long-Term Outcomes in Young Patients Undergoing Percutaneous Coronary Intervention in Macedonia

Zafirovska

Otljanska

Petkoska

et al. 2019

ACC

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The aim was to assess coronary artery disease (CAD) risk factor distribution and long-term outcomes in young patients undergoing percutaneous coronary intervention (PCI) in Macedonia. A total of 12,361 PCI patients (from March 2011 to December 2017) were included in the study. Group 1 included 309 young patients aged ≤40 as the main study group, comparing them to 12,052 older PCI patients (group 2) during the study period. We compared CAD risk factor distribution, clinical and procedure characteristics. Additionally, angiographic data, long-term major adverse cardiac and cerebrovascular events (MACCE) and mortality were analyzed in group 1 patients. Median age was 36±4 years in group 1 and 62±11 years in group 2. Male patients predominated in both groups (88% vs.73%). Positive family history for CAD, smoking and obesity was much more common in the young group (p<0.0001). ST segment elevation myocardial infarction (STEMI) primary PCI was also more frequent with 48% of PCI in the young group (p<0.0001). Multivessel CAD and chronic total occlusion interventions were more common in the older group (51% and 28%, respectively; p<0.0001). Procedure duration (31±0.4 vs. 35±22 min) and fluoroscopy time (9±4 vs. 9±12 min) were similar in both groups. There was no difference in access site bleeding (4.8% vs. 4.3%). During the 3.5-year median follow up, MACCE was present in 1.9% of young patients. In conclusion, positive family history for CAD, obesity and smoking were the most common risk factors in the young PCI population. Young PCI patients usually had single vessel CAD with STEMI being more frequent as the cause for primary PCI. Long-term annual survival exceeded 99% in these patients with excellent prognosis after PCI.

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Section: Discussionsupporting

confidence: 70%

“…Pre-procedural retrograde radial arteriography was performed in all patients to define the radial artery anatomy from mid forearm to ulnobrachial anastomosis and to delineate ulnar artery anatomy as well, thus generating the access roadmap [6][7][8][9][10] .…”

Section: Methodsmentioning

confidence: 99%

Risk Factor Distribution and Long-Term Outcomes in Young Patients Undergoing Percutaneous Coronary Intervention in Macedonia

Zafirovska

Otljanska

Petkoska

et al. 2019

ACC

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“…According to our experience [10][11][12] and results from this observational study preprocedural RA angiography reduces overall procedural time and major access site bleeding complications. Also we noted a significant decrease in primary TRA access site crossover after introducing RA angiography.…”

Section: Discussionmentioning

confidence: 85%

“…A solution of 3 ml of contrast diluted with 7 ml of blood was injected through the cannula or through the side arm of the sheath under fluoroscopy in the posterior‐anterior projection. If there was some variation or tortuosity/spasm of the radial artery, it was negotiated under fluoroscopy control (Figure ).…”

Section: Methodsmentioning

confidence: 99%

Benefit of routine preprocedural radial artery angiography in STEMI patients

Zafirovska

Antov

Kostov

et al. 2018

Cathet Cardio Intervent

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“…The potential advantages of TRA over TFA include increased patient comfort, lower rate of access-site complications, 14 shorter procedure time, lower cost driven by the lack of a need for a closure device, and earlier ambulation and discharge. 15…”

Section: Discussionmentioning

confidence: 99%

Transradial access for flow diversion of intracranial aneurysms: Case series

et al. 2020

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Background Transradial access for neurointerventions offers advantages of fewer access-site complications, reduced procedure time, and greater patient comfort over transfemoral access. Data about transradial access for flow diversion are limited. We share our early experience with transradial access for flow diversion in a relatively large case series. Methods Consecutive patients who underwent Pipeline embolization device (Medtronic) deployment via transradial access were included in the study, irrespective of location and laterality of the intracranial aneurysm. The cases were performed between July 2016 and October 2019. Demographics, aneurysm characteristics, and procedure-related details (including catheter systems used) were recorded and statistically evaluated. Results Thirty-five transradial flow diversion procedures were attempted in 32 patients, of which 33 procedures were successful. In two cases involving left common carotid artery and internal carotid artery access, guide catheter herniation into the aortic arch led to abandonment of transradial access in favor of transfemoral access. The most common aneurysm locations in the transradial access procedures were the posterior communicating artery ( n = 7), ophthalmic artery ( n = 7), and superior hypophyseal artery ( n = 7). Most transradial access procedures (66.7%) were performed using a biaxial catheter system. 6-French Benchmark (Penumbra) and Phenom 27 (Medtronic) were the most commonly utilized guide- and microcatheters, respectively. One patient had intraprocedural subarachnoid hemorrhage. No access-site complications occurred. Conclusion This study demonstrates safety and feasibility of transradial access for Pipeline embolization device deployment and shows the versatility of this approach for different catheter systems. Tortuosity and acute angulation of the left common carotid artery and internal carotid artery were associated with approach failure.

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Total wrist access for angiography and interventions: Procedural success and access site crossover in a high volume transradial center

Cited by 13 publications

References 17 publications

Risk Factor Distribution and Long-Term Outcomes in Young Patients Undergoing Percutaneous Coronary Intervention in Macedonia

Risk Factor Distribution and Long-Term Outcomes in Young Patients Undergoing Percutaneous Coronary Intervention in Macedonia

Benefit of routine preprocedural radial artery angiography in STEMI patients

Transradial access for flow diversion of intracranial aneurysms: Case series

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