scholarly journals Manual extraction of a dislodged and migrated DES from radial artery puncture site

2021 ◽  
Author(s):  
Sophia Khattak ◽  
Subramanya Upadhyaya ◽  
J Nolan ◽  
Ted Lo
Keyword(s):  
Radial Artery ◽  
Local Anaesthetic ◽  
Rare Case ◽  
Puncture Site ◽  
Access Site ◽  
Manual Extraction ◽  
Distal Radial Artery

Abstract This is a rare case of manual retrieval of a dislodged stent from radial artery access site under local anaesthetic. The LAD PCI was complicated by stent distortion which occurred due to in adequate preparation of a calcified, tortuous lesion. The dislodged stent was unable to be retrieved percutaneously and had to be left in the distal radial artery which a few weeks later migrated from the radial artery and taken out manually from the puncture site.

scholarly journals Atraumatic Left Distal Radial Artery Aneurysm

2019 ◽  
Vol 2019 ◽  
pp. 1-4 ◽  
Author(s):  
Joseph Maalouly ◽  
Dany Aouad ◽  
Elias Saidy ◽  
Antonios Tawk ◽  
Georges Baaklini ◽  
...  
Keyword(s):  
Radial Artery ◽  
Rare Case ◽  
Artery Aneurysm ◽  
Operative Management ◽  
Chief Complaint ◽  
Radiological Imaging ◽  
Left Wrist ◽  
Pulsatile Mass ◽  
Left Radial Artery ◽  
Distal Radial Artery

Distal radial artery aneurysms are an uncommon pathological entity in the field of surgery. Moreover, distal radial artery aneurysms of idiopathic etiology are even rarer. Herein, we present a rare case of idiopathic/atraumatic left radial artery aneurysm. A 73-year-old female patient presented with a chief complaint of a pulsatile mass located on her left wrist. Radiological imaging showed the presence of a distal radial artery aneurysm which was successfully surgically excised with subsequent ligation of the radial artery. Some of the etiologies and operative management of distal radial artery aneurysm in the anatomical snuffbox to what is in accordance with the literature are discussed. Distal radial artery aneurysms are rare. Hence, their misdiagnosis may lead to wrongful management and increase in morbidity. The appropriate management of distal radial aneurysm is almost always surgical.

P6524The comparison of radial artery occlusion rate after distal radial artery puncture between hemodialysis and non-hemodialysis patients

2019 ◽  
Vol 40 (Supplement_1) ◽  
Author(s):  
S Yokota ◽  
K Tobita ◽  
T Hayashi ◽  
Y Mashimo ◽  
H Miyashita ◽  
...  
Keyword(s):  
Radial Artery ◽  
Hemodialysis Patients ◽  
Artery Occlusion ◽  
Dialysis Patients ◽  
Puncture Site ◽  
Single Center Study ◽  
Significant Difference ◽  
Radial Artery Occlusion ◽  
Event Rates ◽  
Distal Radial Artery

Abstract Background In recent years it has been attempted to use a distal radial artery (DRA) as a puncture site for cardiac catheterization and intervention. A patency of radial artery is important in hemodialysis patients because the radial artery is source as an arteriovenous shunt. However, the incidence of radial artery occlusion (RAO) is not known after DRA puncture. Purpose To compare RAO rates after DRA puncture between dialysis and non-dialysis patients. Method This was retrospective, observational and single center study. All consecutive 1,533 patients undergoing DRA puncture were analyzed. The primary endpoint is RAO rates. The secondary endpoint is composite bleeding adverse event rates. These endpoints were evaluated by a vascular echocardiography several hours or the next day after the procedure. Result Among 1,533 patients, 26 were dialysis patients and 1,504 were non-dialysis patients. 1,386 people (90.5%) succeeded in puncture. Radial artery occlusion occurred in 7 patients (0.4%), all of whom were non-dialysis patients. There was no significant difference of RAO rate in dialysis patients and non-dialysis patients. Conclusion When performing DRA puncture, the probability of radial artery occlusion is not higher in dialysis patients than non-dialysis patients. The DRA puncture may be one of the option as puncture site even in dialysis patients.

Abstract 14475: Successive Distal Transradial Approach for Coronary Catheterization in the Same Arm

Circulation ◽  
2020 ◽  
Vol 142 (Suppl_3) ◽  
Author(s):  
Takeshi Yamada ◽  
Soichiro Washimi ◽  
yuki matsubara ◽  
Sho Hashimoto ◽  
Norimasa Taniguchi ◽  
...  
Keyword(s):  
Radial Artery ◽  
Bypass Graft ◽  
Coronary Bypass ◽  
Artery Occlusion ◽  
Access Site ◽  
Transradial Approach ◽  
Coronary Catheterization ◽  
Initial Procedure ◽  
Second Procedure ◽  
Distal Radial Artery

Background: The distal transradial approach (dTRA) for coronary catheterization is a newly introduced alternative to the conventional transradial approach. This study investigated how many times the same distal radial artery can be cannulated for coronary catheterization. Methods: A total of 1717 patients underwent 2406 coronary catheterization procedures between April 2018 and March 2020. The dTRA was used as the primary approach whenever feasible in this study period, and the dTRA was used for 1555 patients (90.6%) and 2129 procedures (88.5%). Patients who underwent repeated coronary catheterization after the initial procedure using dTRA were included in this study. The incidence of successive application of dTRA in the same arm and the reasons for access site conversion were investigated. Results: A total of 430 patients were included in this study; of these, in 10 patients, the distal radial artery was cannulated on both sides in the initial procedure. The patient group included 320 men (74.4%), and the mean age was 72.2 ± 10.8 years. A 4-, 5-, or 6-French sheath or sheathless system was used in the initial procedure. A maximum of four successive coronary catheterization procedures, including the initial procedure, were carried out. The second procedure involved the distal radial artery on the same side in 394 cases (89.5%), and the fourth dTRA procedure was possible in 81.7% of the cases. Access site conversion during the follow-up procedure, which was observed in 57 cases, was attributed to radial artery occlusion (17.5%), narrowing of the distal radial artery (33.4%), tortuous route of the right upper limb approach (15.8%), and strategic reasons, such as aortography or coronary bypass graft angiography (15.8%). Conclusions: The dTRA was successfully applied in the same arm in 89.5% of the cases in the second procedure and 81.7% in the fourth coronary catheterization procedure.

scholarly journals Radial Artery Access for Percutaneous Cardiovascular Interventions: Contemporary Insights and Novel Approaches

2019 ◽  
Vol 8 (10) ◽  
pp. 1727 ◽  
Author(s):  
Renato Francesco Maria Scalise ◽  
Armando Mariano Salito ◽  
Alberto Polimeni ◽  
Victoria Garcia-Ruiz ◽  
Vittorio Virga ◽  
...  
Keyword(s):  
Radial Artery ◽  
Structural Interventions ◽  
Access Site ◽  
Transfemoral Approach ◽  
Comprehensive Review ◽  
Transradial Approach ◽  
Novel Approaches ◽  
Cardiovascular Interventions ◽  
Technical Considerations ◽  
Distal Radial Artery

Since its introduction, the transradial access for percutaneous cardiovascular procedures has been associated with several advantages as compared to transfemoral approach, and has become the default for coronary angiography and intervention. In the last 30 years, a robust amount of evidence on the transradial approach has been mounted, promoting its diffusion worldwide. This article provides a comprehensive review of radial artery access for percutaneous cardiovascular interventions, including the evidence from clinical trials of transradial vs. transfemoral approach, technical considerations, access-site complications and limitations, alternative forearm accesses (e.g., ulnar and distal radial artery), and ultimately the use of the radial approach for structural interventions.

scholarly journals Rate of Complications at Early Removal of Compression Bandage After Transradial Coronary Angiography

Kardiologiia ◽  
2019 ◽  
Vol 59 (1) ◽  
pp. 79-83 ◽  
Author(s):  
D. V. Ognerubov ◽  
S. I. Provatorov ◽  
A. S. Tereshchenko ◽  
I. V. Romasov ◽  
O. A. Pogorelova ◽  
...  
Keyword(s):  
Coronary Angiography ◽  
Radial Artery ◽  
Ulnar Artery ◽  
Artery Occlusion ◽  
Compression Bandage ◽  
Puncture Site ◽  
Access Site ◽  
Early Removal ◽  
Group 2 ◽  
Group 1

Purpose: to compare rates of access site complications at early (after 4 hours) and traditional (after 24 hours) removal of a compression bandage after diagnostic transradial (TR) coronary angiography (CA) in patients not receiving anticoagulants.Materials and methods. We included into this study 392 patients (mean age 63±8.7 years, 62.8% men) who underwent transradial coronary angiography. Patients were divided into 2 groups. In group 1 patients (n=221) compression bandage was removed from puncture site in 4 hours after procedure with subsequent control of radial artery patency using presence of pulse metric curve during ulnar artery compression (the reverse Barbeau test with pulse oximeter). In patients of group 2 (n=171) compression band was removed after 24 hours. In both groups control of radial artery patency was carried out after 24 hours using the reverse Barbeau test. Upon detection of radial artery occlusion (RAO) ultrasound imaging of the forearm arteries was performed.Results. No RAO was detected in group 1 while in group 2 number of detected RAO was 15 (8.8%) (р<0.05). Rates of hematomas at puncture site were not significantly different. Puncture site bleeding after band removal requiring repeated banding occurred in 1 patient of group one (0.6%); no such cases were registered in group 2 (p>0.05).Conclusion. Compared with traditional method early removal of compression bandage after TR CA was associated with lower rate of RAO.

Applicability of left distal radial artery access site in ST-segment elevation myocardial infarction; A comparative evaluation with the conventional transfemoral approach

2020 ◽  
pp. 112972982098313
Author(s):  
Elton Soydan ◽  
Mustafa Akın
Keyword(s):  
Myocardial Infarction ◽  
Radial Artery ◽  
Comparative Evaluation ◽  
Complication Rates ◽  
Access Site ◽  
Transfemoral Approach ◽  
St Segment Elevation ◽  
Segment Elevation Myocardial Infarction ◽  
St Segment ◽  
Distal Radial Artery

Background: Left distal radial artery (LDRA) has got high popularity as an alternative safe access site in coronary angiography. However, little is known about its applicability in primary percutaneous coronary intervention (PPCI) in ST-segment elevation myocardial infarction (STEMI) patients. We aimed to assess the convenience of LDRA access in STEMI patients and make the comparative evaluation with the transfemoral (TF) route. Materials and methods: A total of 91 consecutive STEMI patients who underwent PPCI from January to June 2019, were analyzed. Experienced operators, unaware of the study were left free of access site decision. Comparative demographic features and clinical outcomes were recorded during hospitalization. Results: LDRA was used in 30 patients, whereas 61 patients underwent a TF approach. Successful PPCI was achieved in high rates in both groups (LDR: 90% vs TF: 91.8%: p = 0.795). On admission, KILLIP (II, III) class was higher in the LDRA group (23.3% vs 3.4%), whereas stent thrombosis, arhythmias were higher in the TF group (0% vs 6.6% p = 0.151; 6.7% vs 18% p = 0.355 respectively). Puncture time was relatively similar between groups (28.63 vs 28.93 s p = 0.767). Fluoroscopy time, total radiation exposure and hospital duration was found lower in the LDRA group (10.11 vs 13.75 min p < 0.001; 917.87 vs 1940.91 mGy p < 0.001; 4.2 vs 6.2 days p = 0.024 respectively). In-hospital mortality was found higher in the TF group (0% vs 18% p = 0.013). Conclusion: In the acute management of STEMI, LDRA access site can be a convenient alternative to TF approach with shorter hospital duration and complication rates.

Two-Step Distal Radial Artery Cannulation for Challenging Radial Anatomies

Cardiology ◽  
2020 ◽  
Vol 146 (2) ◽  
pp. 144-150
Author(s):  
João Ferreira-Martins ◽  
Pitt O. Lim
Keyword(s):  
Radial Artery ◽  
Ultrasound Guidance ◽  
The Elderly ◽  
Artery Occlusion ◽  
Patient Comfort ◽  
Access Site ◽  
Early Ambulation ◽  
Artery Cannulation ◽  
Coronary Syndromes ◽  
Distal Radial Artery

The radial artery is the preferred access site for cardiac catheterization because of patient comfort, early ambulation, and improved survival in acute coronary syndromes, when compared to the femoral artery route. However, it is associated with a high radial artery occlusion (RAO) rate, and patent haemostasis which can reduce this is extremely hard to implement in a busy clinical practice. Smaller sized sheaths are associated with less RAO but are uncommonly used as they could limit procedural prowess and complexity. Alternatively, the distal radial artery (dRA) approach appears to be safer with observed RAO rates of well under 1 percent without compromising benefits offered by the radial artery access. Default dRA can be accessed by palpation alone in most cases with some practice, and this can be improved further with ultrasound guidance. There is a subset of patients, especially in the elderly, where dRA access can be particularly challenging. To mitigate this, we propose a two-step cannulation strategy and illustrate this with a few cases with difficult dRA and radial artery anatomies.

Access-site complications of the transradial approach: Rare but still there.

2020 ◽  
Vol 16 ◽  
Author(s):  
Stelina Alkagiet ◽  
Dimitrios Petroglou ◽  
Dimitrios N. Nikas ◽  
Theofilos M. Kolettis
Keyword(s):  
Radial Artery ◽  
Artery Occlusion ◽  
Tissue Loss ◽  
Access Site ◽  
Transradial Approach ◽  
Financial Benefits ◽  
Eversion Endarterectomy ◽  
Life Threatening ◽  
Sheath Insertion ◽  
Venous Fistula

: In the past decade, the Transradial Approach (TRA) has constantly gained ground among interventional cardiologists. TRA's anatomical advantages, in addition to patients' acceptance and financial benefits, due to rapid patient mobilization and shorter hospital stay, made it the default approach in most catheterization laboratories. Access-site complications of TRA are rare, and usually of little clinical impact, thus they are often overlooked and underdiagnosed. Radial Artery Occlusion (RAO) is the most common, followed by radial artery spasm, perforation, hemorrhagic complications, pseudoaneurysm, arterio-venous fistula and even rarer complications, such as nerve injury, sterile granuloma, eversion endarterectomy or skin necrosis. Most of them are conservatively treated, but rarely, surgical treatment may be needed and late diagnosis may lead to life-threatening situations, such as hand ischemia or compartment syndrome and tissue loss. Additionally, some complications may eventually lead to TRA failure and switch to a different approach. On the other hand, it is the opinion of the authors that non-occlusive radial artery injury, commonly included in TRA's complications in the literature, should be regarded more as an anticipated functional and anatomical cascade, following radial artery puncture and sheath insertion.

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