scholarly journals Access site complications following transfemoral coronary procedures: comparison between traditional compression and angioseal vascular closure devices for haemostasis

2015 ◽  
Vol 15 (1) ◽  
Author(s):  
Pei-Jung Wu ◽  
Yu-Tzu Dai ◽  
Hsien-Li Kao ◽  
Chin-Hao Chang ◽  
Meei-Fang Lou
Keyword(s):  
Access Site ◽  
Vascular Closure Devices ◽  
Coronary Procedures

scholarly journals Anomalous Medial Branch of Radial Artery: A Rare Variant

2016 ◽  
Vol 59 (3) ◽  
pp. 100-103 ◽  
Author(s):  
Surbhi Wadhwa ◽  
Vandana Tomar
Keyword(s):  
Radial Artery ◽  
Anatomical Variations ◽  
Medial Branch ◽  
Normal Pattern ◽  
Access Site ◽  
Capillary Vessel ◽  
Radial Forearm ◽  
Coronary Procedures ◽  
Technical Failures ◽  
Flexor Carpi Radialis Muscle

Radial artery is an important consistent vessel of the upper limb. It is a useful vascular access site for coronary procedures and its reliable anatomy has resulted in an elevation of radial forearm flaps for reconstructive surgeries of head and neck. Technical failures, in both the procedures, are mainly due to anatomical variations, such as radial loops, ectopic radial arteries or tortuosity in the vessel. We present a rare and a unique anomalous medial branch of the radial artery spiraling around the flexor carpi radialis muscle in the forearm with a high rising superficial palmar branch of radial artery. Developmentally it probably is a remanent of the normal pattern of capillary vessel maintenance and regression. Such a case is of importance for reconstructive surgeons and coronary interventionists, especially in view of its unique medial and deep course.

Comparison of Verapamil versus Heparin as Adjunctive Treatment for Transradial Coronary Procedures: The VERMUT Study

Cardiology ◽  
2018 ◽  
Vol 140 (2) ◽  
pp. 74-82 ◽  
Author(s):  
Matteo Tebaldi ◽  
Simone Biscaglia ◽  
Carlo Tumscitz ◽  
Annamaria Del Franco ◽  
Francesco Gallo ◽  
...  
Keyword(s):  
Radial Artery ◽  
Primary Outcome ◽  
Study Groups ◽  
Adjunctive Treatment ◽  
Access Site ◽  
Double Blind ◽  
Access Site Complication ◽  
Heparin Administration ◽  
Coronary Procedures ◽  
Sheath Insertion

Objective: We sought to demonstrate that the combination of a local vasodilator (verapamil), modern materials, patent hemostasis, and intravenous anticoagulant only in the case of percutaneous coronary intervention, as compared to default heparin administration after sheath insertion, may optimize a combined endpoint, including radial artery oc­clusion (RAO), radial artery spasm (RAS), and access site complication. Methods: This is a prospective, single-center, double-blind randomized trial. Overall, 418 patients undergoing a transradial approach (TRA) for coronary procedures were randomized 1: 1 to receive intraradial verapamil (5 mg) or heparin (5,000 IU) after a 6-Fr sheath insertion. The primary outcome was the 24-h occurrence of RAO (ultrasound confirmation), access site complication, and RAS requiring the bailout administration of vasodilators. Results: The combined primary outcome occurred in 127 (30%) patients. It was significantly lower in patients randomized to verapamil as compared to others (26 vs. 35%, p = 0.03). This was mainly due to a significant reduction in RAS (3 vs. 10%, p = 0.006). The 24-h and 30-day occurrence of RAO did not differ between the study groups. Conclusion: Local administration of verapamil versus heparin reduces RAS, without increasing RAO, which appears to be strictly related to radial artery diameter and hemostasis time.

Outcome off Primary Coronary Angioplasty by Radial Route: Study on 100 Cases

2018 ◽  
Vol 3 (06) ◽  
Author(s):  
Dr. Dilip Ratnani ◽  
Dr. Rekha Ratnani
Keyword(s):  
Hospital Stay ◽  
Radial Artery ◽  
Bleeding Complications ◽  
Access Site ◽  
Transfemoral Approach ◽  
Artery Cannulation ◽  
Catheterization Laboratory ◽  
Cardiac Catheterization Laboratory ◽  
Radial Access ◽  
Coronary Procedures

Recently radial artery is being used as a vascular access route for coronary procedures. Primary angioplasty with transfemoral procedure is associated with high access site bleeding complications due to use of potent antiplatelets and anticoagulants therefore radial access should be preferred if the operators are experienced and familiar with the technique. Methods: Total 100 pa‡…tients were included in the study in which procedure was performed by the trans radial route. All routine laboratory investigations were performed. Support of a temporary pacemaker was kept ready. All patients were prepared according to the Cardiac Catheterization Laboratory Standards. Radial artery cannulation was performed. Results: 100 patients were included in the study selected for radial route. Mean age of the patients who underwent primary CAI was 59±8.4. The most affected artery in the as shown angiography was Left anterior descending (58%) followed by Right coronary artery (41%). Least affected artery was left main (6%) and Ramus intermedius (6%). Mean of diseased vessels was 1.34 ± 1.25. Crossover from radial to femoral route was done on 5 patients of which 2 patients were having radial artery anomaly and in 3 patients arterial puncture was not successful. Mean hospital stay of the patients after procedure was 6.8 ± 2.1. Conclusion: transradial approach for coronary procedures is a safe technique and gives similar clinical results to transfemoral access. Complications at the radial access site are negligible. Length of hospital stay, time to mobilisation and cost all are reduced in the transfemoral approach.

Femoral Closure – Devices and Strategies in 2010

2010 ◽  
Vol 5 (1) ◽  
pp. 93
Author(s):  
Benjamin H Holland ◽  
Robert J Applegate ◽  
◽  
Keyword(s):  
First Generation ◽  
Vascular Complications ◽  
Patient Comfort ◽  
Manual Compression ◽  
Single Centre ◽  
Access Site ◽  
Vascular Closure Devices ◽  
Improve Patient Comfort ◽  
Post Hoc ◽  
Improve Patient

Vascular closure devices (VCDs) reduce the time to haemostasis and ambulation and improve patient comfort compared with manual compression in patients undergoing vascular procedures from a femoral artery access site. Recent large, single-centre studies andpost hocdata from the Acute Catheterization and Urgent Intervention Triage strategY (ACUITY) trial strongly suggest that newer generations of VCD decrease rates of vascular complications compared with manual compression, in contrast to earlier evaluations of first-generation devices. Unfortunately, utilisation of VCDs remains limited and mitigates the potential benefit that could result from expanded use of these devices. Newer entrants into the VCD market such as Starclose and Mynx are based on extravascular closure methodology. These devices address concerns of intravascular components of a VCD; however, whether these devices reduce vascular complications and bleeding has not been evaluated. In this brief article, we will examine these factors in greater detail and suggest an algorithm for VCD use in clinical practice.

Vascular access: femoral versus radial

2018 ◽  
pp. 49-64
Author(s):  
Andrew Wiper ◽  
David H. Roberts
Keyword(s):  
Site Selection ◽  
Coronary Intervention ◽  
Evidence Based ◽  
Access Site ◽  
Arterial Access ◽  
Percutaneous Coronary ◽  
Coronary Procedures ◽  
Ultrasound Guided Puncture ◽  
Guided Puncture ◽  
Evidence Based Guidelines

This chapter discusses arterial access sites for performing coronary angiography and percutaneous coronary intervention with their subsequent benefits and limitations. Access site complications and subsequent management are discussed in detail. New techniques are described (e.g. balloon-assisted tracking, slender techniques, and ultrasound-guided puncture) and evidence-based guidelines discussed. There is discussion on ‘tips and tricks’ by two experienced interventional consultant cardiologists and discussion about alternative arterial access site selection in patients undergoing non-coronary procedures. Finally, there is discussion about future access trends.

scholarly journals Access site management with vascular closure devices for percutaneous transarterial procedures

2010 ◽  
Vol 52 (6) ◽  
pp. 1682-1696 ◽  
Author(s):  
Carlos F. Bechara ◽  
Suman Annambhotla ◽  
Peter H. Lin
Keyword(s):  
Site Management ◽  
Access Site ◽  
Vascular Closure Devices
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