Sheathless Guiding Catheter from a Femoral Approach for Complex PCI- an Unusual Solution for an Often-Encountered Problem

Sheathless guiding catheters are a valuable tool in the catheterization labor and may assist the operator when dealing with heavily calcifies and tortuous vessels. Nevertheless, when hostile anatomy prevents successful PCI from the radial access, transfemoral use of sheathless guide can assist in overcoming these challenges in a safe manner.

P5611Feasibility of distal radial access for carotid interventions: the RADCAR-DISTAL pilot study

European Heart Journal ◽

10.1093/eurheartj/ehz746.0555 ◽

2019 ◽

Vol 40 (Supplement_1) ◽

Author(s):

Z Ruzsa ◽

S Nardai ◽

B Nemes ◽

V Orias ◽

E Vegh ◽

...

Keyword(s):

Carotid Artery ◽

Ultrasound Guidance ◽

Vascular Complications ◽

Patient Comfort ◽

X Ray ◽

Radial Access ◽

Procedural Success ◽

Major Adverse Events ◽

Abstract Aims The aim of our study was to demonstrate the feasibility and safety of the distal transradial approach (DTRA) for carotid artery stenting (CAS). Methods and results We included 209 consecutive patients (151 Trans-Radial Access (TRA) and 58 DTRA) treated in a single center by CAS with cerebral protection between 2016 and 2018. DTRA punctures were performed by ultrasound guidance, and the carotid artery cannulations were done using a 6.5 F coronary sheathless guiding catheter. The groups showed similar demographic profile regarding age, gender and comorbidities, however the proportion of symptomatic patients was significantly higher in the DTRA cohort (DTRA: 75,86% vs. TRA: 46.36% p<0.001). Procedural success rate was similarly high in both groups, while the overall complication rate was very low, with no major adverse events and only a few vascular complications. The cannulation times were similar, while the overall procedure length was slightly higher in the DTRA group. The cumulative X-ray dose was similarly low regardless the access used. Conclusion DTRA is a safe and effective alternative of conventional trans-radial approach for CAS, with a potential to further improve the patient comfort.

Sheathless guiding catheter from a femoral approach for complex percutaneous coronary interventions —An unusual solution for an often‐encountered problem

Clinical Case Reports ◽

10.1002/ccr3.2540 ◽

2019 ◽

Vol 7 (12) ◽

pp. 2545-2547

Author(s):

Zeev Israeli ◽

Irina Nordkin ◽

Alexander Goldberg ◽

Majdi Halabi

Keyword(s):

Percutaneous Coronary Interventions ◽

Femoral Approach ◽

Coronary Interventions ◽

Percutaneous Coronary ◽

Rotational Atherectomy Through Radial Access With a 7.5 Fr Sheathless Guiding Catheter

Revista Española de Cardiología (English Edition) ◽

10.1016/j.rec.2010.09.009 ◽

2011 ◽

Vol 64 (3) ◽

pp. 247-248

Author(s):

Iñigo Lozano ◽

Juan Rondan ◽

Pablo Avanzas ◽

Concepción Suárez

Keyword(s):

Rotational Atherectomy ◽

Radial Access ◽

TCT-226: Radial Access for Primary PCI is Associated with Excellent Longterm Outcome and When Undertaken Selects for Low Risk Cases Compared to the Femoral Approach

The American Journal of Cardiology ◽

10.1016/j.amjcard.2009.08.246 ◽

2009 ◽

Vol 104 (6) ◽

pp. 86D

Keyword(s):

Low Risk ◽

Primary Pci ◽

Radial Access ◽

Femoral Approach ◽

Longterm Outcome

Access-Site Complications of the Transfemoral Approach

Radial Access for Neurointervention ◽

10.1093/med/9780197524176.003.0015 ◽

2021 ◽

pp. 123-128

Author(s):

Stephanie H. Chen ◽

Pascal M. Jabbour ◽

Eric C. Peterson

Keyword(s):

Minimally Invasive ◽

Femoral Artery ◽

Access Route ◽

Access Site ◽

Transfemoral Approach ◽

Femoral Access ◽

Hematoma Formation ◽

Radial Access ◽

Femoral Approach ◽

Life Threatening

The radial access route has significantly lower complications compared to the femoral access route. Often users have become used to the femoral approach and its attendant complications but it is worth reviewing that despite its minimally invasive nature as opposed to open craniotomy, endovascular transfemoral access is certainly not without risk. These risks include life threatening retroperiotenal hematoma formation and local hematoma formation as well as limb threatening occlusion of the femoral artery, which is an end artery thus must be urgently revascularlized in the event of compromise. The complications of femoral access are reviewed as well as strategies for management.

Feasibility of Transradial Coronary Intervention Using a Sheathless Guiding Catheter in Patients With Small Radial Artery

Korean Circulation Journal ◽

10.4070/kcj.2011.41.3.143 ◽

2011 ◽

Vol 41 (3) ◽

pp. 143 ◽

Cited By ~ 16

Author(s):

Young Jin Youn ◽

Junghan Yoon ◽

Sang Woo Han ◽

Jun-Won Lee ◽

Joong Kyung Sung ◽

...

Keyword(s):

Radial Artery ◽

Coronary Intervention ◽

P1814A novel method of transradial approach for left ventricular endomyocardial biopsy

European Heart Journal ◽

10.1093/eurheartj/ehz748.0566 ◽

2019 ◽

Vol 40 (Supplement_1) ◽

Author(s):

M I N G Lan ◽

Q I N G He

Keyword(s):

Radial Artery ◽

Endomyocardial Biopsy ◽

Diagnostic Yield ◽

Clinical Importance ◽

Left Ventricular ◽

Skin Dose ◽

Complication Rates ◽

Transradial Access ◽

Abstract Background Left ventricular endomyocardial biopsy (LV-EMB) may offer a superior diagnostic yield compared with right ventricular endomyocardial biopsy (RV-EMB) in conditions predominantly affecting the LV. Recently, transradial way is used for LV-EMB, and it has lower complication rates and has an advantage of immediate post-procedural ambulation compared with transfemoral technique. Previous reports of transradial LV-EMB need relatively complicated sheathless guiding catheter exchanging. Purpose We aimed at finding a novel and easier transradial method with a 6F sheath and a 6F guiding catheter. Methods and results In this manuscript, we described a method that allowed interventional cardiologists to obtain LV-EMB via transradial access with a 6F sheath and a 6F guiding catheter. This technique was successfully conducted in 25 consecutive patients at our institution. The transradial success rate was 100% (25 of 25). Mild or moderate radial artery spasm occurred in only 1 (4%) patient, but no severe radial spasm was observed. All the patients were performed coronary angiography and left ventricular angiogram according to the indication, and they were performed EMB through the same radial sheaths without sheathless guiding catheter exchanging. Heparin was administered to 100% of patients at a dose of 5000IU. Median fluoroscopy time was 13.45min. Median total skin dose was 1478mGy. Median area product was 15486 cGy·cm2. All biopsy samples were graded as excellent quality. Immediate patient mobilization could be achieved in all patients. Radial artery patency was confirmed by doppler ultrasonography 24 hours after the sheath removal. There were no major complications (pericardial tamponade, life-threatening arrhythmia, cerebrovascular accident or death). Transradial LV-EMB with a 6F sheath Conclusions The present article demonstrates a result of feasibility, safety and efficacy of a novel transradial access for LV-EMB using a 6F sheath and a 6F guiding catheter. This is of clinical importance since this new technique may overcome the currently existing methods, and may be regarded as an interventional “one stop shop” technique.