scholarly journals Transradial Approach Superior to Transfemoral Approach for Guide Catheter Engagement of Right Coronary Artery

2008 ◽  
Vol 1 ◽  
pp. CCRep.S733
Author(s):  
Samir B. Pancholy
Keyword(s):  
Coronary Artery ◽  
Right Coronary Artery ◽  
Transfemoral Approach ◽  
Transradial Approach ◽  
Guide Catheter

scholarly journals Reverse longitudinal stent deformation during percutaneous intervention via the retrograde approach to a chronic total occlusion of the right coronary artery: a case report

2021 ◽  
Vol 5 (1) ◽  
Author(s):  
Claudia Cosgrove ◽  
Marciej Marciniak ◽  
James C Spratt
Keyword(s):  
Coronary Artery ◽  
Right Coronary Artery ◽  
Chronic Total Occlusion ◽  
Unusual Complication ◽  
Mechanical Complication ◽  
Retrograde Approach ◽  
Total Occlusion ◽  
Guide Catheter ◽  
Stent Deformation ◽  
Coronary Stent Implantation

Abstract Background Longitudinal stent deformation (LSD) is an uncommon but recognized mechanical complication of coronary stent implantation, usually occurring at the proximal stent edge due to compression by guide catheter or catheter extensions. Retrograde techniques for chronic total occlusion (CTO) percutaneous coronary intervention expose the distal stent edge to potential interaction with retrograde equipment under a tensioned system. Case summary We describe a case of distal stent edge LSD, occurring during a retrograde approach to a right coronary artery CTO via septal collateral channels. While removing the externalized wire, interaction with the retrograde microcatheter caused compression of the distal end of the newly implanted stents. Discussion This unusual complication highlights the reduced longitudinal strength of newer generation stent platforms and the risks of interaction between retrograde equipment and stents on an externalized wire.

scholarly journals TRANSRADIAL APPROACH FOR CAROTID ARTERY STENTING

2018 ◽  
Vol 7 (4) ◽  
pp. 112-120
Author(s):  
D. U. Malaev ◽  
E. I. Kretov ◽  
V. I. Baystrukov ◽  
A. A. Prokhorikhin ◽  
A. A. Boykov
Keyword(s):  
Coronary Artery ◽  
Carotid Artery ◽  
Aortic Arch ◽  
Carotid Artery Stenting ◽  
Vascular Complications ◽  
Good Alternative ◽  
High Rate ◽  
Transfemoral Approach ◽  
Transradial Approach ◽  
Coronary Artery Stenting

Approximately 20% of ischemic strokes are provoked by stenotic carotid artery lesions. With the growing experience of surgeons and the continued improvement of devices, carotid artery stenting has become an effective alternative to carotid endarterectomy. Traditional access to carotid artery stenting is transfemoral approach. However, due to peripheral artery disease and challenging anatomy of the aortic arch, transfemoral approach may be problematic. A number of randomized trials have proven the effcacy and safety of transradial access for coronary interventions. A similar technique was adapted for coronary artery stenting. The article provides a review of the major studies dedicated to coronary artery stenting via transradial approach, discusses all benefts and limitations as well as provide the guide to select an optimal vascular access, depending on the patient's anatomical characteristics. Transradial approach is shown to be a good alternative to transfemoral approach for coronary artery stenting. However, it is accompanied by a high rate of unsuccessful procedures compared to transfemoral approach. Nevertheless, transradial approach is accompanied by a decrease in the rate of vascular complications, and is preferable for intervening on the right ICA, or on the left with bovine aortic arch.

scholarly journals Robotic-Assisted Percutaneous Coronary Intervention Through Transradial Approach: Experience in 4 Patients with Complex Lesions

2020 ◽  
Vol 47 (2) ◽  
pp. 144-148
Author(s):  
Amornpol Anuwatworn ◽  
Muhammad Ali Kahn ◽  
Tomasz Stys ◽  
Marian Petrasko ◽  
Adam Stys
Keyword(s):  
Percutaneous Coronary Intervention ◽  
Coronary Artery ◽  
Coronary Intervention ◽  
Transfemoral Approach ◽  
Transradial Approach ◽  
Robotic Assisted ◽  
Diagonal Branch ◽  
Percutaneous Coronary ◽  
The Right ◽  
Complex Lesions

Robotic-assisted percutaneous coronary intervention can reduce the exposure of interventional cardiologists to radiation and minimize the risk of occupational orthopedic injuries from wearing heavy protective aprons. The PRECISE (Percutaneous Robotically-Enhanced Coronary Intervention) study showed the efficacy and safety of robotic-assisted procedures for relatively low-risk lesions in single coronary arteries. Several reports have described robotic-assisted treatment of complex high-risk lesions, mostly through the transfemoral approach. We report 4 cases of patients in whom we used the transradial approach to treat complex lesions in the left anterior descending coronary artery with bifurcation balloon angioplasty reconstruction (2 cases), in the ostium of the first diagonal branch, and in the right coronary artery.

Safety and feasibility of transradial use of 8F balloon guide catheter Flowgate2 for endovascular thrombectomy in acute ischemic stroke

2021 ◽  
pp. 159101992110131
Author(s):  
Mario Martínez-Galdámez ◽  
Miguel Schüller ◽  
Jorge Galvan ◽  
Mercedes de Lera ◽  
Vladimir Kalousek ◽  
...  
Keyword(s):  
Mechanical Thrombectomy ◽  
Vascular Anatomy ◽  
High Rate ◽  
Transfemoral Approach ◽  
Transradial Approach ◽  
Patient Demographics ◽  
Guide Catheter ◽  
Successful Approach ◽  
And Performance ◽  
Type 3

Background While Balloon Guide Catheters (BGC) have been shown to increase the rate of reperfusion during mechanical thrombectomy (MT), its implementation with transfemoral approach is at times limited due to unfavorable vascular anatomy. Objective to determine safety, feasibility and performance of the transradial use of 8 F BGC Flowgate 2 during mechanical thrombectomy procedures in patients with unfavorable vascular anatomies (type 3 or bovine arch) Material/Methods: We performed a retrospective cohort study of consecutive transradial mechanical thrombectomies performed with BGC Flowgate 2 between January and December 2019. Patient demographics, procedural and radiographic metrics, and clinical data were analyzed. Results 20 (8.7%) out of 230 overall thrombectomy procedures underwent transradial approach using an 8 F BGC Flowgate. 2 Successful approach was achieved in 17/20 cases, and in 3 cases radial was switched to femoral, after failure. TICI 2 C/3 was achieved in 18 cases (90%), followed by TICI 2 b and 2a in 1 (5%) case respectively. The average number of passes was 1.8. The average radial puncture-to-first pass time was 22 min. Radial vasospasm was observed in 3/20 cases. The Flowgate 2 was found kinked in 4/20 cases (20%), all of them during right internal carotid procedures. There were no postprocedural complications at puncture site, as hematoma, pseudoaneurysm or local ischemic events Conclusion The use of 8 F Balloon Guide Catheter during MT via transradial approach might represent an alternative in selected cases with unfavorable vascular anatomies. Its use in right ICA catheterizations was associated with a high rate of catheter kinking.

scholarly journals Trans-radial Angioplasty of Anomalous Origin of Right Coronary Artery from Left Sinus of Valsalva - A Single-centre Experience

2020 ◽  
Vol 35 (1) ◽  
pp. 28-38
Author(s):  
Sahela Nasrin ◽  
F Aaysha Cader ◽  
Shitil Ibna Islam ◽  
Humayan Kabir ◽  
Masuma Jannat Shafi ◽  
...  
Keyword(s):  
Coronary Artery ◽  
Right Coronary Artery ◽  
Single Case ◽  
Coronary Intervention ◽  
Anomalous Origin ◽  
Sinus Of Valsalva ◽  
Female Ratio ◽  
Guide Catheter ◽  
The Mean ◽  
Left Sinus Of Valsalva

Background: Percutaneous coronary intervention (PCI) to anomalous coronary arteries remain a challenge in current practice, but can be overcome with appropriate techniques and devices. The objective of this study is to explore the challenges and techniques for success in PCI of anomalous origin of right coronary artery from left sinus of Valsalva (RCA-LSV) through the trans-radial route. Methods: This study consisted of 13 patients who underwent PCI for an angiographically significant stenosis in RCA-LSV between November 2017 to March 2020. The procedural details including numbers of catheters used, access, hardware, techniques, duration of procedure, volume of contrast and complications were recorded and statistically analysed. Results: The most frequent site for RCA-LSV is at the level of left main stem (LMS) (53.8%), with 30.8% being just above the LMS level and 5.4% being just below the LMS level. Male to female ratio was 5.5:1. Mean age was 53.7±6.7 (range;42-64) years. 76.9% of our patients were diabetic, 92.3% hypertensive, 84.6% dyslipidaemic, smoker & CKD were 23.1% each. PCI was done successfully in 100% cases. Our default route was transradial for coronary angiography. Angioplasty was performed through trans-radial route in 92.3% and transfemoral in 7.7%, with a single case requiring switch over from radial to femoral route. The average number of guide catheters used was (2±1.0), (range:1-4). We used 4 guide catheters in 2 cases, while the rest of the cases were done by single guide catheter. The guide catheter hooked the coronary ostium selectively and off ostium in 46.2% cases each, while in 7.6% cases it was deeply engaged. Anchoring wire to enhance the guide support was used in 7.7% of cases. The mean duration of the procedure was 33.8 minutes (range: 15-65 minutes), the mean volume of contrast used was 61.5 (range:30-150) ml. We used single stent in 61 % cases and two stents in 39 % cases. Average stent diameter was 2.9 (range;2.5-3.50) mm, length was 28.6 (range;12-43) mm. From among a range of guides used for angioplasty, Judkin’s left (JL) and Judkin’s Right (JR) successfully cannulated the RCALSV in 76.9% & 23.1% respectively. We used Ikari Left (IL) guide catheter in RCA-LSV associated with subclavian tortuosity to enhance guide support. Majority of the lesions stented were of ACC/AHA classification of Type A & B lesions (38.5% each), followed by Type C (23%) lesion. Conclusion: To the best of our knowledge, this is the first report of transradial PCI to RCA-LSV in Bangladesh, describing our experiences and techniques, with locally available hardware. PCI of RCA-LSV through radial route is technically challenging but feasible with reasonable amount of contrast and radiation. Proper localization of ostium and selection of suitable guide catheter like JL or IL is the key to success. Bangladesh Heart Journal 2020; 35(1) : 28-38

Intracoronary thrombolysis and stentless primary percutaneous coronary intervention in an ectatic right coronary artery with large thrombus burden

2020 ◽  
Author(s):  
George Kassimis ◽  
Petros Faliagkas ◽  
Polykarpos Pshochias ◽  
Efstratios Karagiannidis ◽  
Emmanouela Peteinidou ◽  
...  
Keyword(s):  
Myocardial Infarction ◽  
Coronary Artery ◽  
Right Coronary Artery ◽  
Micro Computed Tomography ◽  
Aspiration Thrombectomy ◽  
St Segment Elevation ◽  
Segment Elevation Myocardial Infarction ◽  
Guide Catheter ◽  
St Segment ◽  
Intracoronary Thrombolysis

A 58-year-old man was admitted to our center with an inferior ST-segment elevation myocardial infarction. A coronary angiogram showed an ectatic right coronary artery (RCA) occluded at mid vessel by a significant clot burden quantified by micro-computed tomography. Guide catheter-directed intracoronary thrombolysis with low-dose tenekteplase resulted in regaining RCA flow, when numerous efforts of manual and ‘mother-child’ thrombectomy had failed to achieve. A stentless strategy was followed with final thrombolysis in myocardial infarction 3 flow and angiographically insignificant stenosis remaining in the RCA. The combination of intracoronary thrombolysis and a stentless strategy is a safe and effective treatment in ST-segment elevation myocardial infarction patients with ectatic arteries and large thrombus burden when repeat manual aspiration thrombectomy fails.

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