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Transulnar Compared With Transradial Artery Approach as a Default Strategy for Coronary Procedures: A Randomized Trial The Transulnar or Transradial Instead of Coronary Transfemoral Angiographies Study (The AURA of ARTEMIS Study). Hahalis G, Tsigkas G, Xanthopoulou I, Deftereos S, Ziakas A et. al. Greece. Abstract BACKGROUND: The ulnar artery is rarely selected for coronary angiography…

Transradial diagnosis and intervention of supraaortic vessels. Turgeman Y, Suleiman K, Feldman A, Bushari LI. Israel. Abstract BACKGROUND: The transradial approach (TRA) is becoming widespread, mainly for coronary interventions, but it has rarely been used for diagnosis and even less for therapeutic treatment of supraaortic arterial vessel (SAAV) atherosclerotic disease. OBJECTIVES: We report our last…

Risk-treatment paradox in the selection of transradial access for percutaneous coronary intervention Wimmer NJ, Resnic FS, Mauri L, Matheny ME et al. Boston, MA. Abstract BACKGROUND: Access site complications contribute to morbidity and mortality during percutaneous coronary intervention (PCI). Transradial arterial access significantly lowers the risk of access site complications compared to transfemoral arteriotomy. We…

Same-Day Discharge After Percutaneous Coronary Intervention: A Meta-Analysis Brayton KM, Patel VG, Stave C, de Lemos JA, Kumbhani DJ. OBJECTIVES: To assess the safety of same-day discharge in patients undergoing percutaneous coronary intervention (PCI). BACKGROUND: The safety of same-day discharge has previously been evaluated primarily in small, single-center studies. METHODS: We conducted a meta-analysis of…

Transradial versus transfemoral approach for primary percutaneous coronary interventions in elderly patients. Secco GG, Marinucci L, Uguccioni L, Parisi R, Uguccioni S, Fattori R. BACKGROUND: The use of transradial approach (TRA) in the STEMI setting is still debated because of the worry that TRA intervention can lead to a delay in the reperfusion time, especially…

Balloon-assisted deep intubation of guide catheter for direct thromboaspiration in acute myocardial infarction – A technical report Surender Deora, Sanjay Shah, Tejas Patel We have read with great interest the letter by Bagur et al. regarding deep coronary intubation for direct thromboaspiration . It is of no doubt that direct thrombus aspiration with deep intubation…

Transradial PCI and Same Day Discharge: A Winning Team? Editorial Comments Eltigani Abdelaal, MD and Olivier F. Bertrand, * MD, PhD, FSCAI, Quebec Heart-Lung Institute, Quebec City, Canada Faced with rising healthcare costs, and with an aging population, healthcare systems are increasingly challenged globally to reduce costs of healthcare delivery, without compromising access to contemporary therapies. Technical advances in percutaneous coronary…

Remaining challenges and opportunities for improvement in percutaneous transradial coronary procedures.  Rao SV, Bernat I, Bertrand OF. The adoption of transradial coronary angiography and coronary intervention is growing because of emerging data on its potential advantages over the femoral approach. As the adoption of radial procedures increases, it is important to understand the remaining challenges…

Comparison Between Transradial and Transfemoral Percutaneous Coronary Intervention in Acute ST-Elevation Myocardial Infarction. Ibebuogu UN, Cercek B, Makkar R, Dinh H, Kwarteng C, Mirocha J, Hussaini A, Singh S, Dohad S, Shah PK, Khorsandi M, Kar S. Transradial (TR) access is increasingly being used in percutaneous coronary intervention (PCI). However, its role in PCI for…

Entrapment of a looped/kinked catheter in the brachial artery and its successful retrieval during transradial coronary catheterization. Waked A, Khoueiry G, Bhat T. Transradial access for cardiac catheterization is widely accepted as a safe and viable approach with markedly decreased incidence of major accessrelated complications compared to the transfemoral approach. Minor catheter looping or kinking…

Management of Transradial Access for Coronary Angiography Schueler A, Black SR, Shay N. Amy Schueler et. al. The transradial approach for percutaneous coronary intervention and angiography has been shown to be a safe and effective alternative to the traditional transfemoral approach. Used extensively throughout Europe for the past 15 years, this technique has recently gained…

Ipsilateral transulnar catheterization in patients with ipsilateral radial artery occlusion. Kwan TW, Ratcliffe JA, Chaudhry M, Huang Y, Wong S, Zhou Z, Pancholy S, Patel T. BACKGROUND: The transradial approach to percutaneous coronary intervention (PCI) has recently gained popularity among interventionalists. However, radial artery occlusion (RAO) limits the ability for repeat catheterization. In current practice, transulnar…

Transradial percutaneous iliac intervention, a feasible alternative to the transfemoral route. Cortese B, Peretti E, Troisi N, Siquilberti E, Setti M, BACKGROUND: Percutaneous angioplasty for atherosclerotic iliac disease is commonly performed via the femoral and/or brachial route. In the coronary field a transradial approach has been shown to reduce both major and minor access site bleedings,…

Learning curve in transradial cardiac catheterization: procedure- related parameters stratified by operators’ transradial volume. Kasasbeh ES, Parvez B, Huang RL, et al. OBJECTIVE: To determine whether radial artery access is associated with a reduction in fluoroscopy time, procedure time, and other procedural variables over a 27-month period during which the radial artery approach was incorporated in…

Prone position coronary angiography due to intractable back pain: another merit of transradial approach compared to transfemoral approach. Kwon SW, Cha JJ, Rhee JH., Republic of Korea We report a case of prone position coronary angiography due to intractable back pain via left transradial approach. When a patient cannot lie down in a supine position,…

Direct aspiration of large thrombi in acute myocardial infarction using a standard 6 fr guide catheter via the transradial approach. Shimada Y, Kino N, Fukumoto H.,Japan A large thrombus load on the culprit coronary artery of patients with acute myocardial infarction (MI) is associated with increased procedural complications and adverse coronary events following angioplasty. This…

Feasibility and safety of 7F sheathless guiding catheter during transradial coronary intervention. Kwan TW, Cherukuri S, Huang Y, Pancholy S, Daggubati R, Liou M, Coppola J, Saito S. OBJECTIVE: The aim of our study is to assess the feasibility, safety, and rate of radial artery occlusion (RAO) using 7F sheathless guiding catheter in a large…

Coronary cannulation through mirror-image right aortic arch during right transradial approach: a rare case report with review of literature. Patel T, Shah S, Pancholy S. Department of Cardiology, Sheth V.S. General Hospital and Smt. N.H.L. Municipal Medical College, Ahmedabad-380 006, India. Although right aortic arch (RAA) is a rare developmental anomaly, it can create a…

Balloon-Assisted Sheathless Transradial Intervention (BASTI) Using 5 Fr Guiding Kwan TW, Ratcliffe JA, Huang Y, Liou M, Pancholy S, Patel TM. BACKGROUND: The sheathless approach to transradial percutaneous coronary intervention (PCI) has recently gained popularity among interventionalists. However, technical problems and lack of approved equipment in the United States has limited its applicability. We describe…

Cannulating LIMA graft using right transradial approach: Two simple and innovative techniques. Patel T, Shah S, Patel T, Ahmedabad, India. Angiography and intervention of a LIMA (left internal mammary artery) graft cannot be performed easily while working through right transradial approach (TRA), because of complexity in anatomical relations of right and left subclavian arteries with…

Comparison of transradial and femoral approaches for percutaneous coronary interventions: A systematic review and hierarchical Bayesian meta-analysis. Bertrand OF, Blisle P, Joyal D, Costerousse O, Rao SV, Jolly SS, Meerkin D, Joseph L. Quebec Heart and Lung Institute, Quebec City, Quebec, Canada; McGill University, Montreal, Quebec, Canada. BACKGROUND: Despite lower risks of access site-related complications with…

Comparison of A Priori Versus Provisional Heparin Therapy on Radial Artery Occlusion After Transradial Coronary Angiography and Patent Hemostasis (from the PHARAOH Study) Pancholy SB, Bertrand OF, Patel T. Systemic anticoagulation decreases the risk of radial artery occlusion (RAO) after transradial catheterization and standard occlusive hemostasis. We compared the efficacy and safety of provisional heparin use only when…

When size matters: Feasibility of using larger diameter radial catheters Abdulla Damluji MD, MPH, Ian C. Gilchrist MD, FSCAI Pioneer transradial angiography (TRA) in the 1940s was thwarted by the engineering limits imposed by the available primeval 8- to 10-French catheters that were passed into the radial artery and the resultant arterial spasm and thrombosis [1].…

Feasibility of complex coronary and peripheral interventions by trans-radial approach using large sheaths Santiago F. Coroleu, Francesco Burzotta, Carlos Fernandez-G³mez et al. Background: Trans-radial approach (TRA) reduces vascular access-site complications but has some technical limitations. Usually, TRA procedures are performed using 5 Fr or 6 Fr sheaths, whereas complex interventions requiring larger sheaths are approached…

Shorter duration of hemostatic compression is associated with a lower incidence of early and chronic RAO, without increase in bleeding complications, although maintaining radial patency during hemostatic compression, eliminates the adverse effect of duration of compression.A single center experience with same-day transradial-PCI patients: A contrast with published guidelines Ian C. Gilchrist MD, Denise A. Rhodes,…

Percutaneous antegrade transarterial treatment of iatrogenic radial arteriovenous fistula Summaria F, Romagnoli E, Preziosi P, Italy. Site of access vascular complications is infrequent after transradial interventions. We report the case of a 66-year-old man referred to our hospital because of right forearm swelling, oedema and pain with functional forearm disability, 1 year after a transradial…

Impact of vascular approach (transradial vs. transfemoral) on the efficacy of thrombus aspiration in acute myocardial infarction patients. Sciahbasi A, Burzotta F, Rigattieri S et al. Italy. BACKGROUND: Manual thrombus aspiration improves the efficacy of percutaneous coronary interventions (PCIs) in ST-elevation acute myocardial infarction (STEMI). The transradial approach (TRA) is an emerging vascular approach for…

Comparison of Percutaneous Coronary Intervention Safety Before and During the Establishment of a Transradial Program at a Teaching Hospital. Leonardi RA, Townsend JC, Bonnema DD et al. South Carolina. This study sought to examine the safety of percutaneous coronary intervention (PCI) before and during de novo establishment of a transradial (TR) program at a teaching hospital.…

Transradial measurement of transvalvular pressure gradient in the setting of mechanical aortic and mitral valve prostheses using a coronary fractional flow reserve guidewire Vales L, Cherukuri S, Kwan T from USA. Abstract Accurate measurement of transvalvular pressure gradients is essential to comprehensively evaluate whether mechanical prosthetic valves are functioning normally. Direct measurements can be technically…

Vascular complications and access crossover in 10,676 transradial percutaneous coronary procedures Burzotta F, Trani C, Mazzari MA, et al. BACKGROUND: Randomized trials have shown that transradial approach, compared with transfemoral, reduces vascular complications (VCs) of coronary procedures in selected patients. Yet, radial approach is associated to a variety of access-site VC as well as to…

Is it possible to do an angiography via radial artery without vasospasm? A. Goldsmit, C. Sztejfman, F. Chiminela, et al. from Argentina & US. Aims: We sought to evaluate Nalbufine Chloridrate (NC) safety and efficacy in preventing vasospasm during coronary angiography (CA), elective carotid angiography (ECA) and percutaneous coronary intervention (PCI) via the radial artery. Methods…

Left Radial versus Right Radial Approach for Coronary Artery Catheterization :A Prospective Comparison. Dominici M, Diletti R, Milici C, et al. Background: Despite several advantages of the transradial over the transfemoral approach, the use of transradial access for coronary interventions in daily practice is still low. Major limitations are the technical and anatomical issues related…

Vascular complications and access crossover in 10,676 transradial percutaneous coronary procedures. Burzotta F, Trani C, Mazzari MA, et al. BACKGROUND:Randomized trials have shown that transradial approach, compared with transfemoral, reduces vascular complications (VCs) of coronary procedures in selected patients. Yet, radial approach is associated to a variety of access-site VC as well as to a…

Proceedings of TRICO 2011 from the desk of Tejas Patel Friends, TRICO 2011, the Seventh International Transradial Intervention Course was held on October 15th and 16th, 2011. We started preparing for it from beginning of February 2011 onwards. Hotel bookings were done by the end of March 2011. We decided to do the live cases…

Arteriovenous fistula of the wrist after transradial coronary intervention. Heart Lung. 2011 Aug 9. [Epub ahead of print] Yang JH, Gwon HC, Park JE et al. South Korea. Abstract The transradial approach for percutaneous coronary intervention (PCI) is a common route, but is associated with a few local complications. Access site complications, such as hematoma,…

Initial experience with transradial access for carotid artery stenting. Vasc Endovascular Surg. 2011 Aug; 45(6):499-503. Mendiz OA, Sampaolesi AH, Londero HF et al. Argentina. Abstract We report our experience using transradial access (TRA) for carotid artery stenting (CAS). Eighty-eight patients underwent CAS using a non femoral approach, 79 of them by TRA. Carotid artery stenting…

Routine use of the transradial approach in primary percutaneous coronary intervention: procedural aspects and outcomes in 2209 patients treated in a single high-volume centre. Vink MA, Amoroso G, Dirksen MT et al. The Netherlands. Heart. 2011 Aug 31. [Epub ahead of print] Vink MA, Amoroso G, Dirksen MT et al. The Netherlands.   Abstract Objective:…

Reduction of scatter radiation during transradial percutaneous coronary angiography: A randomized trial using a lead-free radiation shield. Politi L, Biondi-Zoccai G, Nocetti L et al. Italy. Abstract Background: Occupational radiation exposure is a growing problem due to the increasing number and complexity of interventional procedures performed. Radial artery access has reduced the number of complications…

Impella assisted transradial coronary intervention in patients with acute coronary syndromes and cardiogenic shock: Case series. Bell BP, Iqtidar AF, Pyne CT. Abstract Operators may feel apprehension when considering the transradial approach in patients with cardiogenic shock due to concerns of the need for femoral access for mechanical support. There is however potential benefit of…

Perforation of the sinus of valsalva by guiding catheter during the percutaneous coronary intervention via the right transradial approach: A very unusual complication. Tomassini F, Gagnor A, Varbella F. Abstract Iatrogenic dissection of the sinus of Valsalva or of the ascending aorta is a rare, but potentially fatal event, during the percuteneous coronary intervention (PCI).…

Evaluation of the “Learning Curve” for Left and Right Radial Approach During Percutaneous Coronary Procedures. Sciahbasi A, Romagnoli E, Trani C et al. Italy. Abstract The transradial approach for percutaneous coronary procedures may be effectively performed through the right radial approach (RRA) or left radial approach (LRA) after an appropriate “learning curve.” However, studies evaluating…

Reaccessing an Occluded Radial Artery: A “Proximal Entry” Technique. Patel T, Shah S, Sanghavi K, Pancholy S. Abstract Radial artery occlusion (RAO) is an infrequent but important consequence of transradial access. It prevents subsequent use of the same radial artery for coronary angiography and intervention. We describe a new “proximal entry” technique in 3 cases…

A technique to access difficult to find upper extremity veins for right heart catheterization: The levogram technique. Pancholy SB, Sweeney J. Abstract Upper extremity venous access provides a safer alternative for performance of right heart catheterization compared to femoral venous access. We describe a technique to access deep veins of the upper extremity, in patients…

A single center experience with same-day transradial-PCI patients: A contrast with published guidelines. Gilchrist IC, Rhodes DA, Zimmerman HE. Abstract Objectives: Our goal was to compare recently published Consensus Statement from the SCAI/ACC on appropriateness for same-day PCI with patient characteristics from a real-world same-day PCI experience in the United States. Background: Recent practice statement…

Transradial arterial access for coronary and peripheral procedures: Executive summary by the transradial committee of the SCAI. Caputo RP, Tremmel JA, Rao S, Gilchrist IC, Pyne C, Pancholy S, Frasier D, Gulati R, Skelding K, Bertrand O, Patel T. Abstract In response to growing U.S. interest, the Society for Coronary Angiography and Interventions recently formed…

Impact of transradial and transfemoral coronary interventions on bleeding and net adverse clinical events in acute coronary syndromes. Hamon M, Mehta S, Steg PG et al. France. Abstract Aims: The aim of the present study was to examine the impact of the transradial approach (TRA), in comparison to the transfemoral approach (TFA), on PCI-related bleeding…

Transradial arterial access for coronary and peripheral procedures: Executive summary by the transradial committee of the SCAI. Caputo RP, Tremmel JA, Rao S, Gilchrist IC, Pyne C, Pancholy S, Frasier D, Gulati R, Skelding K, Bertrand O, Patel T. Abstract In response to growing U.S. interest, the Society for Coronary Angiography and Interventions recently formed…

Impact of transradial and transfemoral coronary interventions on bleeding and net adverse clinical events in acute coronary syndromes. Hamon M, Mehta S, Steg PG et al. France. Abstract Aims: The aim of the present study was to examine the impact of the transradial approach (TRA), in comparison to the transfemoral approach (TFA), on PCI-related bleeding…

Successful Transradial Intervention for Two Lesions with Dual Anomalous Origins of Coronary Arteries Masuda N, Matsukage T, Ikari Y. Japan Abstract A 76-year-old male was admitted to our hospital for effort angina pectoris. His coronary computed tomography and coronary angiography revealed anomalous origins of the left anterior descending artery (LAD) from the proximal right coronary…

A Simple Approach for the Reduction of Knotted Coronary Catheter in the Radial Artery During the Transradial Approach Patel T, Shah S, Pancholy S. Abstract Development of a catheter knot is uncommon but still a matter of concern for a catheterizing cardiologist. There are only a few case reports of percutaneous catheter unknotting in the…

Minimally invasive transradial intervention using sheathless standard guiding catheters. anei Y, Kwan T, Nakra NC, Liou M, Huang Y, Vales LL, Fox JT, Chen JP, Saito S. Abstract Objectives: We evaluated a sheathless transradial technique for interventions using standard five and six French nonhydrophilic guiding catheters. Background: Miniaturization of transradial interventions may serve to improve…

Safety and Feasibility of Transradial Approach for Coronary Bypass Graft Angiography and Intervention. Han H, Zhou Y, Ma H et al. China. Abstract The transradial approach (TRA) is commonly applied for coronary catheterization. However, there are few reports on the safety and feasibility of transradial catheterization in patients with prior coronary artery bypass graft (CABG)…

Transradial cardiac catheterization: A review of access site complications. Kanei Y, Kwan T, Nakra NC, Liou M, Huang Y, Vales LL, Fox JT, Chen JP, Saito S. Abstract Transradial catheterization (TRC) has been associated with a lower incidence of major access site related complications as compared to the transfemoral approach. With the increased adoption of…

Transradial Embolization of a Bleeding Renal Angiomyolipoma. Abrams J, Yee DC, Clark TW. USA. Abstract Renal angiomyolipoma (AML) is a benign neoplasm with a propensity to bleed among patients with tumors exceeding 4 cm in diameter but can be effectively treated with transarterial embolization to arrest or prevent hemorrhage. We report the use of transradial…

Effect of duration of hemostatic compression on radial artery occlusion after transradial access. Pancholy SB, Patel TM. Abstract Objectives: To evaluate the effect of duration of hemostatic compression on the incidence of radial artery occlusion (RAO) after transradial coronary intervention. Background: RAO occurs in 2-10% of patients after transradial access. The effect of duration of…

Successful use of an extra-long hydrophilic-coated sheath in enlarged aorta to overcome extreme tortuosity of right subclavian artery via transradial approach during coronary angiography. Tomassini F, Gagnor A, Varbella F. Abstract The transradial approach (TRA) has gained popularity in recent years mainly because of the significantly decreased access-site complications and the greater patient comfort it…

Right coronary artery from the left sinus of valsalva: Multislice CT and transradial PCI. Bagur R, Gleeton O, Bataille Y et. al., Canada. Abstract A 42-year-old-woman presented with de novo crescendo angina. Thallium-scintigraphy showed inferior ischemia. Coronary angiogram revealed a right coronary artery (RCA), originating from the left sinus of Valsalva with a severe proximal…

Short- and Long-Term Follow-up of Percutaneous Coronary Intervention for Chronic Total Occlusion through Transradial Approach: Tips for Successful Procedure from a Single-Center Experience. Liu W, Wagatsuma K, Toda M et al. China. Abstract There are limited data regarding transradial percutaneous Background: To coronary intervention (PCI) for chronic total occlusion (CTO). Objective: assess the feasibility and safety of…

The use of a guide catheter extension system as an aid during transradial percutaneous coronary intervention of coronary artery bypass grafts; an extended case series. Farooq V, Mamas MA, Fath-Ordoubadi F, Fraser DG. Manchester Heart Centre, Oxford Road, Manchester, United Kingdom. Abstract AIMS:Prior coronary artery bypass graft (CABG) surgery is one of the main predictors…

Transradial complex left main trifurcation intervention. Catheterization and Cardiovascular Interventions Hesham Hussein, Hsiu-Yu Fang, Chiung-Jen Wu. Abstract Trifurcation lesions, especially around the left main coronary artery (LMCA), are occasionally encountered. Complex lesions, involving the bifurcation or the trifurcation of the unprotected LMCA, represent a real challenge for interventional cardiologists. Trifurcation lesions intervention reported to have…

Sheathless transradial intervention using standard guide catheters Catheterization and Cardiovascular Interventions Abstract Objectives: Our aim was to report our preliminary experience performing complex transradial interventions using a sheathless technique with standard large bore nonhydrophilic guiding catheters. Background: A major limitation of transradial percutaneous coronary intervention (PCI) is the inability to use large guides because of…

Prevalence of transradial coronary angiography and intervention in China: Report from the Transradial coronary intervention Registration Investigation in China (TRI-China). Wang L, Yang Y, Zhou Y, Abstract OBJECTIVE: To investigate the prevalence of TRA and TRI in China in the years 2006 and 2007. METHOD: About 47wQbNPTDJp9hMYdvogK2hAUiHsGeiybwaWe36bwtRQ3UTpYV7YuZ8FV5j9nauFCWwcjM6dTzpL5s2N79Rp5unwdMvc8ZKU and 2008. RESULTS: Data was collected from 163…

A randomized comparison of TR band and radistop hemostatic compression devices after transradial coronary intervention. Rathore S, Stables RH, Pauriah M, Abstract BACKGROUND:The transradial route for coronary intervention has proven to be safe, effective, and widely applicable in different clinical situations. Several compressive hemostatic devices have been introduced that have shown to be safe and…

Transradial complex left main trifurcation intervention. Hussein H, Fang HY, Wu CJ. Abstract Trifurcation lesions, especially around the left main coronary artery (LMCA), are occasionally encountered. Complex lesions, involving the bifurcation or the trifurcation of the unprotected LMCA, represent a real challenge for interventional cardiologists. Trifurcation lesions intervention reported to have high overall major adverse…

Recanalization and reuse of early occluded radial artery within 6 days after previous transradial diagnostic procedure. Babunashvili A, Dundua D. Abstract Late radial artery (RA) thrombosis occurs in 3-9% after transradial interventions. RA occlusion has made this approach unsuitable for repeat interventions and obviated the need for alternative vascular access for catheterization, e.g. left RA…

Implementation of the Transradial Approach for Coronary Procedures is Not Associated with an Elevated Complication Rate and Elevated Radiation Patient Exposure. Lehmann R, Ehrlich JR, Weber V, AbstractThe transradial approach for coronary procedures is associated Background: with a low complication rate, but specific training is considered mandatory. Procedural characteristics (contrast Methods: dye: CD; fluoroscopy time:…

Sterile radial artery granuloma after transradial procedures: a unique and avoidable complication. Zellner C, Ports TA, Yeghiazarians Y, Abstract Trans-radial cardiac catheterization has lower rates of arterial access site complications. Hydrophilic-coated sheaths designed specifically for trans-radial procedures have resulted in numerous reports of a foreign body reaction to retained material. Although this is a self-limited…

TRICO 2010 – A GRAND SUCCESS – Comments from international guest faculties A few words about TRICO 2010 “I found TRICO 2010 to be a perfect blend of technique and technology. As with previous TRICOs, the emphasis on TRI technique was maintained, with an excellent display of multi-device studded complex PCI, exuding evidence-based approach, and…

TRICO 2010 Proceedings Friends, TRICO 2010, the Sixth International Transradial Intervention Course was held on October 30th and 31st, 2010. First five TRICOs were traditionally held in the month of January since 2005. However, because of some compelling reasons, it was not possible for us to organise it in January this year and after a…

Angiographic evaluation of right upper-limb arterial anomalies: implications for transradial coronary interventions. Fujii T, Masuda N, Tamiya S, OBJECTIVES:Upper-limb arterial anomalies are sometimes encountered during transradial coronary procedures. These anomalies may contribute to procedural failure or to vascular complications, and are a major reason why many operators tend to avoid transradial procedures. We investigated the…

Pushing the limits forward: Transradial superficial femoral artery stenting. Trani C, Tommasino A, Burzotta F. Percutaneous revascularization of superficial femoral artery (SFA) is increasingly carried out to treat patients with peripheral vascular disease and either intermittent claudication or critical limb ischemia. Transradial vascular access is increasingly adopted for invasive procedures due to reduced access-site complications…

Transradial iliac artery intervention with dual downstream embolic protection. Pitta SR, Barsness GW, Lerman A, Mathew V, Gulati R We report a case of a thrombotic common iliac lesion with concern for elevated risk of downstream embolization during intervention. In this case, a transradial approach enabled the novel, simultaneous deployment of two embolic protection devices,…

Randomized Comparison of Transradial Coronary Angiography Via Right or Left Radial Artery Approaches. Kanei Y, Nakra NC, Liou M Previous studies have shown that the right radial approach encounters more tortuosity than the left radial approach during transradial coronary angiography. The objective of this study was to compare the procedural difficulty of the right and…

Progress in angioplasty for chronic total occlusions. Shigeru Saito MD, FACC, FSCAI. As everybody can agree, chronic total occlusion (CTO) lesion is the lesion subset remaining in the last frontier for percutaneous coronary intervention (PCI). Because of the difficulty in randomization, we cannot have enough evidence for the clinical significance of successful recanalization of these…

Recanalization and reuse of early occluded radial artery within 6 days after previous transradial diagnostic procedure. Babunashvili A, Dundua D Late radial artery (RA) thrombosis occurs in 3-9% after transradial interventions. RA occlusion has made this approach unsuitable for repeat interventions and obviated the need for alternative vascular access for catheterization, e.g. left RA (with…

Transradial approach for percutaneous closure of patent ductus arteriosus with the Amplatzer duct occluder II: A case report. Cassese S, Losi MA, Rapacciuolo A. Percutaneous patent ductus arteriosus (PDA) closure is a safe and feasible treatment, and it is recommended over surgical approach in the majority of cases. Amplatzer duct occluder (ADO-AGA Medical Corporation, Golden…

Radial versus femoral access for orally anticoagulated patients. Antonios G. Ziakas, Konstantinos C. Koskinas, Stavros Gavrilidis et al. OBJECTIVES: To prospectively compare the efficacy and procedural safety of the radial versus femoral route for cardiac catheterization during uninterrupted warfarin therapy. Background: The optimal treatment strategy for cardiac catheterization in patients receiving long-term oral anticoagulation has…

Transradial Coronary Intervention-Radiant or Brilliant? András Komócsi and Dániel Aradi. We read with great interest the recently published review of Rao et al. regarding the clinical benefits of using the transradial approach for percutaneous coronary interventions (PCI). The paper outstandingly demonstrates how deeply a technical modification might influence our current clinical practice. Despite these benefits,…

Transradial access in percutaneous coronary interventions : Technique and procedure. Dahm JB, Wolpers HG, Becker J et al. After showing significantly lower complication rates in diagnostic coronary angiography, the radial artery access was successfully introduced as a useful vascular access site for transradial percutaneous coronary intervention in order to enhance patients’ comfort and reduce hospital…

No free lunch: Transradial access in patients on coumadin. TT Tsai. The Ying and Yang of percutaneous coronary intervention (PCI) continues to focus on balancing the risks of ischemic complications with bleeding. Once considered a “necessary evil” of PCI, efforts to decrease bleeding has taken center stage as mounting evidence links bleeding events to increased…

Transradial approach to lower extremity interventions. Korabathina R, Yadav SS, Coppola JT, Staniloae CS. Department of Cardiovascular Medicine, Saint Vincents Catholic Medical Center, New York, USA. Percutaneous interventions of the coronary and peripheral vessels have historically been performed using a femoral artery approach. There has been increasing recognition of post-procedural bleeding complications and its impact…

Sheathless transradial intervention using standard guide catheters. From AM, Gulati R, Prasad A, Rihal CS. The Division of Cardiovascular Diseases, Mayo Clinic College of Medicine and Mayo Foundation Rochester, Minnesota. OBJECTIVES: Our aim was to report our preliminary experience performing complex transradial interventions using a sheathless technique with standard large bore non-hydrophilic guiding catheters. BACKGROUND:…

Left or Right, Transradial Access for All. Martinez CA, Cohen MG. Cardiovascular Division, University of Miami Miller School of Medicine, Miami, FL, USA. “That which we persist in doing becomes easier, not that the task itself has become easier, but that our ability to perform it has improved.” – Ralph Waldo Emerson (1803–1882) After Campeau…

Transradial access for primary percutaneous coronary intervention: the next standard of care? Amoroso G, Kiemeneij F. Primary percutaneous coronary intervention (PPCI) has been acknowledged by the most recent European guidelines to be the preferred treatment for ST elevation myocardial infarction (STEMI). Patients undergoing PPCI are expected to receive a broad spectrum of anticoagulants and antiplatelet…

Randomized Clinical Trial on Short-Time Compression with Kaolin-Filled Pad: A New Strategy to Avoid Early Bleeding and Subacute Radial Artery Occlusion after Percutaneous Coronary Intervention. Politi L, Aprile A, Paganelli C, Amato A, Zoccai GB, Sgura F, Monopoli D, Rossi R, Modena MG, Sangiorgi GM. Interventional Cardiology, Policlinico Hospital, University of Modena and Reggio Emilia,…

Low rate of conversion to transfemoral approach when attempting both radial arteries for coronary angiography and percutaneous coronary intervention: a study of 1,826 consecutive procedures. Guedes A, Dangoisse V, Gabriel L, Jamart J, Chenu P, Marchandise B, Schroeder E. AIMS: Despite a proven safety profile, the transradial approach (TRA) for coronary procedures is regarded by…

Reduction in spasm with a long hydrophylic transradial sheath. Caussin C, Gharbi M, Durier C, Ghostine S, Pesenti-Rossi D, Rahal S, Brenot P, Barri M, Durup F, Lancelin B., Hôpital Marie Lannelongue, Le Plessis Robinson. OBJECTIVES: We aimed to assess the efficiency of a long hydrophilic sheath in reducing radial spasm for transradial approach. BACKGROUND:…

Arteria lusoria diagnosed by transradial coronary catheterization. Kai-Hang Yiu, Wing-Sze Chan, Man-Hong Jim, Wing-Hing Chow, Hong Kong, China. A 51-year-old man with a history of hypertension presented with chest pain and was admitted for elective coronary angiogram. Coronary angiogram via radial artery, a 0.035-inch (190-cm) guidewire (Terumo Corp., Tokyo, Japan) could only advance directly to…

Chronic kidney injury in patients after cardiac catheterisation or percutaneous coronary intervention: a comparison of radial and femoral approaches (from the British Columbia Cardiac and Renal Registries). Vuurmans T, Byrne J, Fretz E, Janssen C, Hilton JD, Klinke WP, Djurdjev O, Levin A., Royal Jubilee Hospital, Victoria, British Columbia, Canada. BACKGROUND: Acute kidney injury (AKI)…

Successful recanalization of chronic total occlusion of the superior mesenteric artery by transradial approach. Kim WT, Ahn SG, Lee JW, Sung JK, Lee SH, Yoon J., Korea. It is a challenge to confirm chronic mesenteric ischemia (CMI) as a cause of gastrointestinal (GI) symptoms such as postprandial epigastric bloating, anorexia, and debilitating weight loss. Endovascular…

Analysis of right radial artery for transradial catheterization by quantitative angiography – anatomical consideration of optimal radial puncture point. Fujii T, Masuda N, Toda E, Shima M, Tamiya S, Ito D, Matsukage T, Ogata N, Morino Y, Tanabe T, Ikari Y. Japan. OBJECTIVES: To determine the optimal radial puncture point, we analyzed the anatomy and…

Feasibility and application of single 5F multipurpose catheter in coronary and peripheral angiography via a transradial approach. Fang Y, Yang C, Wang X, Zhou L, Wang H, Zeng C, China. OBJECTIVE: Atherosclerosis is a systemic disease, in which coronary and peripheral angiographies are required to be done at the same time in a large number…

Feasibility and safety of transradial approach for catheter ablation of idiopathic left ventricular tachycardia. He B, Jiang H, Lu Z, Zhang M, Hu X, Yang B, Huang H, Wu G, Wan J, Liu H, Wang X, Huang C., People’s Republic of China. BACKGROUND: The feasibility and safety of the transradial approach for catheter ablation of…

Incidence, range, and clinical effect of hemoglobin changes within 24 hours after transradial coronary stenting. Bertrand OF, Larose E, Rodés-Cabau J, Rinfret S, Déry JP, Bagur R, Gleeton O, Nguyen CM, Proulx G, De Larochellière R, Poirier P, Costerousse O, Roy L. Canada. Anemia and major bleeding are independent predictors of outcomes after acute coronary…

Radial artery thrombosis following transradial coronary angiography: incidence and rationale for treatment of symptomatic patients with low-molecular-weight heparins. Zankl AR, Andrassy M, Volz C, Ivandic B, Krumsdorf U, Katus HA, Blessing E. Germany. BACKGROUND: Transradial access for diagnostic and therapeutic coronary angiography gains more and more popularity because of its advantages over the femoral approach,…

Decreasing operators’ radiation exposure during coronary procedures: The Transradial Radiation Protection Board. Miles Behan, Peter Haworth, Paul Colley, Michael Brittain, Andrew Hince, Michael Clarke, Azad Ghuran, Mrinal Saha, David Hildick-Smith, Brighton and Sussex University Hospitals NHS Trust, Brighton, United Kingdom. AIM: Transradial coronary procedures are associated with decreased vascular access site complications and other benefits…

Treatment of an iatrogenic subclavian artery dissection. Christian Spies, David Fergusson. Subclavian artery dissection is a rare complication of cardiac catheterization. The usual reason for entering this vessel is to access the origin of the left internal mammary artery (LIMA) when this has previously been used, or is being considered, as a bypass graft. We…

Identifying factors that predict the choice and success rate of radial artery catheterisation in contemporary real world cardiology practice : a sub-analysis of the PREVAIL study data. Pristipino C, Roncella A, Trani C, Nazzaro MS et al.,San Filippo Neri Hospital, Rome, Italy. AIMS : To assess: the reasons behind an operator choosing to perform radial…

Transulnar artery approach for percutaneous coronary intervention: an alternative route in a patient with challenging transfemoral access and hypoplastic radial artery. Chiam PT, Lim VY. Department of Cardiology, National Heart Centre, 17 Third Hospital Avenue, Mistri Wing. Transradial coronary angiography and intervention has become a popular technique due to reduced local and bleeding complications, easier…

Adjusted weight anticoagulation for radial approach in elective coronarography: the AWARE coronarography study. Schiano P, Barbou F, Chenilleau MC, Louembe J, Monsegu J. Department of cardiology, Val-de-Grâce Military Institute, Paris, France. AIMS: To evaluate the feasibility and safety of an anticoagulation adapted regimen for transradial coronary angiography. METHODS AND RESULTS: We randomly assigned 162 consecutive…

Effects of trimetazidine on endothelial dysfunction after sheath injury of radial artery. Park KH, Park WJ, Kim MK, Park DW, Park JH, Kim HS, Cho GY. Korea. Transradial coronary artery angiography (TRCAG) can have harmful effects on the radial artery as a conduit for coronary artery bypass graft surgery. The aim of this study was…

Comparison of door-to-balloon times for primary PCI using transradial versus transfemoral approach. Pancholy S, Patel T, Sanghvi K, Thomas M. OBJECTIVES: The objective of this study was to compare door-to-balloon times and other variables in ST-segment elevation myocardial infarction (STEMI) patients undergoing primary percutaneous coronary intervention (PCI) using transfemoral or transradial approaches. BACKGROUND: Transradial PCI…

Transradial cardiac procedures: the state of the art. Bethan Freestone, Jim Nolan, UK. Since the first catheterisation of a human heart was performed by Werner Forssmann in 1929, access site practice has undergone considerable evolution and technical refinement. Early operators accessed the left side of the heart using a surgical technique to expose and cannulate…

All in favor of radial percutaneous coronary intervention, raise your (patient’s) hand: Editorial Comment. Steven R. Bailey, MD, FSCAI, San Antonio, Texas. Time to arterial access and myocardial reperfusion have been demonstrated to be critical in decreasing mortality in the setting of acute ST segment Myocardial Infarction (STEMI). An important observation from two recent meta-analyses…

Managing Radial Access Vascular Complications: Recognizing complications associated with transradial access and available management options. Ehab A. Eltahawy and Christopher J. Cooper. Among patients undergoing diagnostic cardiac catheterization, transradial access leads to improved quality of life after the procedure, is strongly preferred by patients, and reduces hospital costs.1 Transradial coronary angiography and angioplasty is safe,…

Radial Artery PCI Makes Same-Day Discharge Possible for Many Patients. When interventional cardiologists use the radial artery in the wrist to thread slender catheters into the heart for angioplasty and stenting, many patients can safely go home the same day-even some with chronic medical conditions and complex blockages-according to a study presented today at the…

Treatment of Radial Artery Pseudoaneurysm Using a Novel Compression Device. Michael Liou, Frank Tung, Yumiko Kanei, Tak Kwan. ABSTRACT:Radial artery pseudoaneurysm is an extremely rare complication associated with transradial catheterization. We report 2 cases of pseudoaneurysm of the radial artery that were successfully treated using the Terumo TR band. We believe that the safety, efficiency,…

Is Transradial Cerebral Angiography Feasible and Safe? A Single Center’s Experience. Jo KW, Park SM, Kim SD, Kim SR, Baik MW, Kim YW. Koreo. OBJECTIVE: Although a transradial angiography is accepted as the gold standard for cardiovascular procedures, cerebral angiography has been performed via transfemoral approach in most institutions. The purpose of this study is…

Overcoming Anatomic Challenges to Transradial Access: An overview for interventionists who are considering transradial access training. Christopher Pyne and Tift Mann. The benefits of transradial access have been well documented in numerous studies during the past 2 decades, and it is now accepted as an alternative approach for coronary interventional procedures. A disadvantage of the…

Commitment Pays Off When Training for Transradial PCI. There is increasing interest in using the radial artery in the wrist, rather than the femoral artery in the groin, for passing slender catheters into the heart during angioplasty and stenting, largely because it is safer and more comfortable for patients. But when launching a program to…

SCAI: Transradial program may require time investment, but ‘worth it’. San Diego — When launching a program to train cardiologists in the radial technique, cardiac cath labs should be prepared to face logistical challenges for a substantial period of time, despite the safety and comfort benefits to the patient, based on a case study presented…

Impact of Length and Hydrophilic Coating of the Introducer Sheath on Radial Artery Spasm During Transradial Coronary Intervention. A Randomized Study. Sudhir Rathore, Rodney H. Stables, Maheshwar Pauriah, Abdul Hakeem, Joseph D. Mills, Nick D. Palmer, Raphael A. Perry, John L. Morris. Department of Cardiology, Liverpool Heart and Chest Hospital, Liverpool, United Kingdom. OBJECTIVES: The…

Hydrophilic-Coated Radial Sheaths: A Leap Forward, But Watch Where You Land. Ian C. Gilchrist, Mark Kozak, Pennsylvania. Radial artery spasm is one of the impediments to transradial cardiac catheterization. Although the incidence of spasm as a reason for procedural failure appears to markedly decrease with operator experience, it never completely disappears. In addition to preventing…

Radial Artery Access Ted E. Feldman, MD, FSCAI, Chief Medical Editor, BMC Today. Radial access is gaining in both interest and application in catheterization laboratory practice in the United States. The gains are based not only on a growing database on the radial approach, but also due to the way patients react to radial versus…

The Impact of Radial Access on PCI Complications: Advantages of this approach in the outcomes of percutaneous coronary intervention. John P. Vavalle, MD, and Sunil V. Rao, MD. The transradial approach for percutaneous coronary intervention (PCI) was first introduced by Campeau in 1989. However, the use of the radial artery for vascular access in PCI…

Radial Access for Primary PCI: The role of radial artery access in the evolution of percutaneous angioplasty and in minimizing complications.   Martial Hamon, MD, and Javed Ehtisham, MD Primary percutaneous coronary intervention (PCI) has been shown to be more effective than thrombolytic therapy for treating ST-segment elevation myocardial infarction (STEMI). In terms of death,…

Transradial Basics: A practical approach to coronary catheterization and intervention via the radial artery. Matthew L. Bilodeau, MD, PHD, and Daniel I. Simon, MD, FACC, FAHA, FSCAI. The use of a percutaneous transradial artery approach for diagnostic coronary angiography was first described by Dr. Lucein Campeau.1 Dr. Ferdinand Kiemeneij adapted equipment and advanced the use…

The Transradial Approach: Does your fellowship training program teach it? Jennifer A. Tremmel, MD, MS. For more than 40 years, the femoral approach has been the dominant method of vascular access for diagnostic and interventional procedures in the United States.1 Brachial artery cannulation, the original access point for coronary procedures, was quickly relegated to a…

Transradial PCI allows more patients to be discharged the same day. Michael O’Riordan. San Diego, CA – Same-day discharge following radial-artery PCI is possible for many patients, including patients not considered candidates for same-day discharge by current criteria [1]. Investigators report that older and diabetic patients and those who underwent complex procedures, as well as…

Trans-Radial Coronary Angiography. Haroon Rashid| May 13, 2010. Trans radial access is much more comfortable for the subject as it does not compromise the mobility in the immediate post procedure period unlike trans femoral procedures. More over, access site bleeding problems are much lower compared to femoral arterial access. But the down side of trans…

Coronary Artery Occlusion and Myocardial Infarction Caused by Vasospasm within a Myocardial Bridge. Vales L, Kanei Y, Fox J. Myocardial bridging is a common congenital coronary anomaly that is clinically silent in the majority of cases. Case reports suggest myocardial ischemia and infarction can be caused by myocardial bridging. The proposed mechanisms by which myocardial…

Bilateral percutaneous ulnar artery approach for retrograde chronic total occlusion intervention. Hussein H, Gan HW, Fang HY, Wu CJ. Cardiology Department, National Heart Institute. The transradial approach for coronary diagnostic and therapeutic interventions is a well-established, safe, and effective technique that has shown a success rate comparable to that of the transfemoral approach for chronic…

Will the Transradial Approach Become the Preferred Approach in Subclavian Artery Stenting? Craig Walker, Cardiovascular Institute of the South, Houma, Louisiana. Subclavian artery stenting is well established in the therapy of subclavian artery stenosis resulting in subclavian steal,arm claudication, myocardial ischemia in patients with prior or intended coronary artery bypass utilizing the internal mammary artery,…

Femoral pseudoaneurysms and current cardiac catheterization: Evaluation of risk factors and treatment. Batric Popovica, Luc Freysza, Frric Chometona, Julien Lemoinea, Mazen Elfarrab, Michael Angioia, Christine Selton-Sutya, Christian de Chilloua, Etienne Aliota. OBJECTIVES: We sought to determine the incidence of femoral pseudoaneurysm (FPA) following cardiac catheterization, identify the risk factors for FPA and factors influencing therapeutic…

Incidence and predictors of radial artery spasm during transradial coronary angiography and intervention. JIA De-an, ZHOU Yu-jie, SHI Dong-mei, LIU Yu-yang, WANG Jian-long, LIU Xiao-li, WANG Zhi-jian, YANG Shi-wei, GE Hai-long, HU Bin, YAN Zhen-xian, CHEN Yi, GAO Fei. BACKGROUND: Radial artery spasm (RAS) is the most common complication in transradial coronary angiography and intervention.…

Coronary artery disease in orthotopic liver transplantation: pretransplant assessment and management. Ehtisham J, Altieri M, Salam© E, Saloux E, Ollivier I, Hamon M., France. The prevalence of coronary artery disease in end-stage liver disease is only now being recognized. Liver transplant patients are a high risk subgroup for coronary artery disease, even if asymptomatic. Coronary…

Analysis of Peripheral Arterial Bends that interfere with Coronary Catheterization. Naoki Masuda, Takashi Matsukage, Nobuhiko Ogata, Yoshihiro Morino, Teruhisa Tanabe, Yuji Ikari. OBJECTIVES: The aim of this study was to analyze the characteristics of peripheral arterial bends that interfere with coronary catheterization. BACKGROUND: Complex aortic and peripheral arterial bends are important factors in unsuccessful coronary…

The Transradial Approach to Percutaneous Coronary Intervention. Historical Perspective, Current Concepts, and Future Directions. Sunil V. Rao, Mauricio G. Cohen, David E. Kandzari, Olivier F. Bertrand, Ian C. Gilchrist, Florida, California, Canada, Pennsylvania. Sunil V. Rao, Mauricio G. Cohen, David E. Kandzari, Olivier F. Bertrand, Ian C. Gilchrist, Florida, California, Canada, Pennsylvania. Periprocedural bleeding complications…

Transradial approach to subclavian artery stenting. Yu J, Korabathina R, Coppola J, Staniloae C., New York. BACKGROUND: Subclavian artery angioplasty has been traditionally performed via the transfemoral approach. Transradial access is becoming increasingly used for coronary as well as for certain peripheral vascular beds. We describe our experience with transradial access for subclavian artery stenting.…

Transradial approach in patients with ST-elevation myocardial infarction treated with abciximab results in fewer bleeding complications: data from EUROTRANSFER registry. Siudak Z, Zawislak B, Dziewierz A, Rakowski T, Jakala J, Bartus S, Noworolnik B, Zasada W, Dubiel JS, Dudek D., Poland. OBJECTIVES: Our aim was to investigate the safety and efficacy of transradial approach, predictors…

Impact of introducer sheath coating on endothelial function in humans after transradial coronary procedures Dawson EA, Rathore S, Cable NT, Wright DJ, Morris JL, Green DJ., Research Institute for Sport and Exercise Sciences, Liverpool John Moores University, and Liverpool Heart and Chest Hospital, Liverpool, England, UK. BACKGROUND: The aim of this study was to compare…

Transradial and Transbrachial Arterial Approach for Simultaneous Carotid Angiographic Examination and Stenting Using Catheter Looping and Retrograde Engagement Technique. Hsiu-Yu Fang, Sheng-Ying Chung, Cheuk-Kwan Sun, Ali A Youssef, Anuj Bhasin, Tzu-Hsien Tsai, Cheng-Hsu Yang, Chien-Jen Chen, Hisham Hussein, Chiung-Jen Wu, Hon-Kan Yip, Taiwan. BACKGROUND: The purpose of this study was to introduce a novel and…

Assessment of acute injuries and chronic intimal thickening of the radial artery after transradial coronary intervention by optical coherence tomography. Yonetsu T, Kakuta T, Lee T, Takayama K, Kakita K, Iwamoto T, Kawaguchi N, Takahashi K, Yamamoto G, Iesaka Y, Fujiwara H, Isobe M, Japan. AIMS: Transradial coronary intervention (TRI) introduces a trauma to the…

Preventing Leg Amputations in Critical Limb Ischemia With Below-the-Knee Drug-Eluting Stents. The PaRADISE (PReventing Amputations using Drug eluting StEnts) Trial. Andrew J. Feiring, Mari Krahn, Lori Nelson, Amy Wesolowski, Daniel Eastwood, and Aniko Szabo, Division of Cardiac and Vascular Intervention, Columbia-St. Mary’s Medical Center, Milwaukee, Wisconsin, Department of Population Health, Division of Biostatistics, Medical College…

Letter to the Editor of Transradial Approach to All Interventional Procedures. A Matter of the Learning Curve. Tomasz Pawlowski, Tomasz Kulawik, Robert J. Gil. Recently, JACC: Cardiovascular Interventions published a report describing the role of transradial approach (TRA) in interventional cardiology (1). Its authors pointed out that the TRA is as feasible and effective as…

Effectiveness of enoxaparin for prevention of radial artery occlusion after transradial cardiac catheterization. Hasan Feray, Cemil Izgi, Diler Cetiner, Ebubekir Emre Men, Yelda Saltan, Ayhan Baltay and Reyhan Kahraman, Department of Cardiology, Gaziosmanpasa Hospital, Istanbul, Turkey, Esat Is Cad. Sifa Sok, 15/4, 34710 Moda, Kadikoy, Istanbul, Turkey. The aim of this study was to assess…

Radial vs. femoral approach for primary percutaneous coronary intervention in octogenarians. Michael Koutouzisa, Gran Matejkaa, Gran Olivecronab, Lars Gripa, Per Albertssona. Background: The transradial approach is associated with fewer bleeding complications during percutaneous coronary interventions (PCIs) but is more technically challenging and associated with prolonged times during intervention. The aim of this study is to…

Successful Percutaneous Endovascular Management of Acute Post-traumatic Superior Mesenteric Artery Dissection Using a Transradial Approach. Patel T, Kuladhipati I, Shah S. Acute aortic dissection extending into the superior mesenteric artery (SMA) following a blunt trauma is an extremely rare complication. We report a case of acute post-traumatic SMA dissection presented with an acute abdominal syndrome. Computed…

Treatment for LMCA ostial stenosis using a bifurcation technique with a retrograde approach. Shinichi Shirai, Tatsuki Doijiri, Masashi Iwabuchi, Division of Cardiology, Kokura Memorial Hospital, Kitakyushu, Japan. A 69-year-old man who underwent coronary artery bypass surgery in February 2008. The surgery included grafting of the left internal thoracic artery (LITA) to the diagonal branch (D1)…

The way to the heart is through the wrist. New procedure reduces recovery time. Michael Glover, St. Mary’s Medical Center in Blue springs. Blue Springs, MO – Dr. Daniel Dunker, a cardiologist at St. Mary’s Medical Center, specializes in a catheterization procedure that is safer and more comfortable for patients. It’s called transradial catheterization. It’s…

Open Sesame Technique for chronic total occlusion. Shigeru Saito, MD, FACC, FSCAI, Division of Cardiology and Catheterization Laboratories, Heart Center of Shonan Kamakura General Hospital, 1202-1 Yamazaki, Kamakura City, Japan. Angioplasty for chronic total occlusion (CTO) of the coronary artery is still technically challenging. New techniques to improve the success rate are still required. The…

Arterial access and door-to-balloon times for primary percutaneous coronary intervention in patients presenting with acute ST-elevation myocardial infarction. Aaron N. Weaver, Rick A. Henderson, Ian C. Gilchrist, Steven M. Ettinger, Heart and Vascular Institute, Penn State University, Hershey Medical Center, Hershey, Pennsylvania. Department of Medicine, Section of Cardiology, Wake Forest University, Baptist Medical Center, Winston-Salem,…

Coronary intervention with 4-French catheters. Satoshi Takeshita, Shinji Tanaka, Shigeru Saito, Department of Cardiology and Catheterization Laboratory, Shonan Kamakura General Hospital, Kamakura, Japan.   OBJECTIVES: We sought to determine whether 4-Fr percutaneous coronary intervention (PCI) is associated with technical difficulties that might have an unfavorable impact on procedural parameters. BACKGROUND: Four-Fr PCI is often associated…

Sanneke P.M. de Boer, Cynthia M. Westerhout, R. John Simes, Christopher B. Granger, Felix Zijlstra, Eric Boersma, for the PCAT-2 (Primary Coronary Angioplasty Versus Thrombolysis-2) Trialists Collaborators Group, Erasmus Medical Center, Rotterdam, the Netherlands, University of Alberta, Edmonton, Alberta, Canada, National Health and Medical Research Council Clinical Trials Centre, Sydney, Australia, Duke University Medical Center,…