scholarly journals Balloon internal fixation- a novel approach to manipulate catheter knot

2021 ◽  
Author(s):  
xianliang Yan ◽  
Tao Sun
Keyword(s):  
Coronary Angiography ◽  
Internal Fixation ◽  
Radial Approach ◽  
Novel Approach ◽  
Percutaneous Coronary ◽  
Angiography Catheter

Trans-radial approach (TRA) is nowdays a more common approach during percutaneous coronary angiography and intervention. Catheter knot is rare but still a matter of concern for a catheterizing cardiologist. Hence, we describe our case of catheter unknotting using balloon internal fixation of angiography catheter.

scholarly journals Percutaneous trans-ulnar versus trans-radial arterial approach for coronary angiography and angioplasty, a preliminary experience at an Egyptian cardiology center

2020 ◽  
Vol 72 (1) ◽  
Author(s):  
Mohammad Shafiq ◽  
Hesham Boushra Mahmoud ◽  
Malak Lamie Fanous
Keyword(s):  
Coronary Angiography ◽  
Radial Artery ◽  
Ulnar Artery ◽  
Coronary Intervention ◽  
Radial Approach ◽  
Percutaneous Coronary ◽  
Procedural Time ◽  
Coronary Procedures ◽  
Doppler Evaluation ◽  
The Right

Abstract Background Trans-ulnar approach was proposed primarily for elective procedures in patients not suitable for trans-radial approach that was introduced two decades ago. The trans-ulnar approach is as safe and effective as the trans-radial approach for coronary angiography and intervention. Aim This study’s aim was to assess the feasibility and safety of the trans-ulnar approach in coronary procedures as a preliminary experience for operators experienced in trans-radial approach with no/minimal trans-ulnar approach experience at an Egyptian center. Results Vascular access in 120 patients was selected randomly for coronary angiography and angioplasty—80 through radial and 40 through ulnar approach. Patients were examined for local complications and Doppler evaluation to both radial and ulnar arteries a day after the procedure was done. Ulnar approach success was 82.5% versus 93.7% in the radial group; failure of ulnar artery puncture was the only cause of crossover in the ulnar group, while occurrence of persistent spasm was the leading cause of crossover in the radial group followed by radial artery tortuosity. The procedure time of coronary angiography and percutaneous coronary intervention of the ulnar group was significantly higher than that of the radial group (P value = 0.011 and 0.034, respectively). The mean caliber of the right ulnar artery was 2.45 ± 0.38, slightly larger than that of the radial artery 2.33 ± 0.38 at the level of the wrist, but this difference was statistically non-significant. Conclusion Our study demonstrated that ulnar access with experienced radial operators and in our patients is a safe and practical approach for coronary angiography or angioplasty, without any major complications. Bearing in mind its high success rate, it can be used when a radial artery is not useful for the catheterization or as a default approach on the expense of slightly longer procedural time.

scholarly journals Comparison of Radial and Femoral Approaches for Coronary Angiography with or without Percutaneous Coronary Intervention in Relation to Vascular Access Site Complications

2021 ◽  
Author(s):  
◽  
Jonele Maree Woodhead
Keyword(s):  
Cardiovascular Disease ◽  
Percutaneous Coronary Intervention ◽  
Coronary Angiography ◽  
Vascular Access ◽  
Coronary Intervention ◽  
P Value ◽  
Complication Rates ◽  
Access Site ◽  
Radial Approach ◽  
Percutaneous Coronary

<p>Background A major population health objective in New Zealand is to reduce the incidence and impact of cardiovascular disease. Cardiovascular disease (CVD) remains New Zealand's leading cause of death (41%). This high demand on health services indicates the need for improved therapies and treatment. Significant advances in percutaneous coronary intervention (PCI) offers many patients who would not typically be eligible for treatment, the chance for a better quality of life living with coronary artery disease (CAD). At present femoral access is primarily used for coronary angiography and or PCI procedures, however more recently there has been a gradual shift to using the radial access approach. Study objective The study's objective was to look at comparing the different access sites used for coronary angiography (CA) and/or percutaneous coronary intervention (PCI) and the significance of the rates of vascular access site complications. The research question considered was; "Is there a significant difference in the vascular access site complication rates when comparing radial to femoral approaches for coronary angiography?"  Methodology and design A cohort study design used observational prospective data on radial approaches and compared this with historical retrospective data on femoral approaches. The secondary (comparative) data was extracted from historical records, from earlier research I had completed. The collection of the secondary data involved strict criteria so that the observational study participants had similar baseline characteristics to ensure validity of this study. One hundred participants were recruited for each (prospective and retrospective) database and then compared and analysed. Findings The use of a radial approach for CA and PCI has a significant decrease in combined vascular access site complications (haematoma, vasovagal and arterial bleed), (p value 0.001), OR 0.28 (0.13-0.62). Haematoma is the main vascular complication (p value 0.009), OR 0.29 (0.11-0.74). Conclusion This study, although small, can be used as a pilot study for a more detailed and bigger national study within New Zealand. From the results it is clear there is a significant decrease in the vascular site complication rates when a radial approach is undertaken for CA and/or PCI. Through education and clinical practice, the radial approach would ensure better patient safety, satisfaction and comfort which would help reduce the patients length of stay and increase patients treated with timely discharges. It could also help decrease the nurses' workload caring for the patient with the radial approach due to the lesser complication rates. More extensive use of radial approaches for CA and or PCI would ensure the above benefits for the patients, staff and the organisation.</p>

Practice patterns, feasibility and efficacy of coronary artery angiography using distal radial approach

2020 ◽  
Vol 41 (Supplement_2) ◽  
Author(s):  
T Kajiya ◽  
J Takaoka ◽  
R Mukai ◽  
T Inoue ◽  
T Ninomiya ◽  
...  
Keyword(s):  
Coronary Angiography ◽  
Ad Hoc ◽  
Coronary Intervention ◽  
Total Radiation ◽  
Procedure Time ◽  
Transradial Approach ◽  
Catheterization Laboratory ◽  
Radial Approach ◽  
Novel Approach ◽  
Approach Group

Abstract Background Most patients undergo coronary angiography by transradial approach. However, recently distal radial approach has been introduced as a novel approach for coronary angiography and intervention. There is uncertainty on the feasibility and safety of distal radial approach for coronary angiography. Methods All consecutive 1450 coronary angiography cases (distal radial approach 237 cases, conventional transradial approach 1213 cases) between October 2018 and December 2019 were included in this study. Emergency coronary angiography cases and ad hoc coronary intervention cases were excluded. Patients were stratified into distal radial approach and conventional radial approach subgroups. Baseline characteristics, contrast amount, procedure time, radiation amount, fluoroscopy time, and complications in catheterization laboratory were statistically analyzed. Results There were no significant differences in age and gender between distal radial vs transradial groups: mean age, 70.8±10.5 vs 70.8±11.0 years; % of males, 77.2% vs 66.9%. Procedure time was significantly shorter in distal radial approach group (28.7±13.3 min vs 32.3±14.2 min, p&lt;0.05) and total radiation amount during procedure was significantly less in distal radial approach group (366.4±189.5 ml vs 412.9±220.3 mGy, p&lt;0.05). Conclusions Coronary angiography with distal radial approach decreases the procedure time and total radiation amount. It is feasible and safe in most stable patients. Funding Acknowledgement Type of funding source: None

scholarly journals Comparison of Radial and Femoral Approaches for Coronary Angiography with or without Percutaneous Coronary Intervention in Relation to Vascular Access Site Complications

2021 ◽  
Author(s):  
◽  
Jonele Maree Woodhead
Keyword(s):  
Cardiovascular Disease ◽  
Percutaneous Coronary Intervention ◽  
Coronary Angiography ◽  
Vascular Access ◽  
Coronary Intervention ◽  
P Value ◽  
Complication Rates ◽  
Access Site ◽  
Radial Approach ◽  
Percutaneous Coronary

<p>Background A major population health objective in New Zealand is to reduce the incidence and impact of cardiovascular disease. Cardiovascular disease (CVD) remains New Zealand's leading cause of death (41%). This high demand on health services indicates the need for improved therapies and treatment. Significant advances in percutaneous coronary intervention (PCI) offers many patients who would not typically be eligible for treatment, the chance for a better quality of life living with coronary artery disease (CAD). At present femoral access is primarily used for coronary angiography and or PCI procedures, however more recently there has been a gradual shift to using the radial access approach. Study objective The study's objective was to look at comparing the different access sites used for coronary angiography (CA) and/or percutaneous coronary intervention (PCI) and the significance of the rates of vascular access site complications. The research question considered was; "Is there a significant difference in the vascular access site complication rates when comparing radial to femoral approaches for coronary angiography?"  Methodology and design A cohort study design used observational prospective data on radial approaches and compared this with historical retrospective data on femoral approaches. The secondary (comparative) data was extracted from historical records, from earlier research I had completed. The collection of the secondary data involved strict criteria so that the observational study participants had similar baseline characteristics to ensure validity of this study. One hundred participants were recruited for each (prospective and retrospective) database and then compared and analysed. Findings The use of a radial approach for CA and PCI has a significant decrease in combined vascular access site complications (haematoma, vasovagal and arterial bleed), (p value 0.001), OR 0.28 (0.13-0.62). Haematoma is the main vascular complication (p value 0.009), OR 0.29 (0.11-0.74). Conclusion This study, although small, can be used as a pilot study for a more detailed and bigger national study within New Zealand. From the results it is clear there is a significant decrease in the vascular site complication rates when a radial approach is undertaken for CA and/or PCI. Through education and clinical practice, the radial approach would ensure better patient safety, satisfaction and comfort which would help reduce the patients length of stay and increase patients treated with timely discharges. It could also help decrease the nurses' workload caring for the patient with the radial approach due to the lesser complication rates. More extensive use of radial approaches for CA and or PCI would ensure the above benefits for the patients, staff and the organisation.</p>

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