T Ransradial Peripheral Vascular Intervention Using Fowler’s Position and Terumo R2P System for Patients With Heart Failure

BackgroundPositioning a patient on the catheterization table is important for proper cardiac or respiratory function during peripheral vascular interventions (PVIs). Fowler’s position, where the patient’s head is a 45-degree angle, is more effective in reducing venous blood volume returning to the heart from the periphery compared to the supine position. The Terumo R2P® system has been developed for transradial PVI.Case presentationTwo patients with heart failure (HF) underwent lower-extremity PVI in Fowler’s position to prevent worsening HF. Because their head position was opposite the C-arm of the X-ray machine, the left radial artery was selected as the access site. The Terumo R2P® system was used for transradial PVI. We successfully treated superficial artery diseases with long shaft balloons and rapid-exchange Terumo R2P® Misago® stents. ConclusionsAlthough lower-extremity PVI using Fowler’s position and the Terumo R2P® system has several limitations, including device availability and technical complexity, it may be effective for particular patients who have higher risk of worsening HF in the supine position.