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Chapter-064 Radial Angioplasty: Tips and Tricks

BOOK TITLE: CSI: Cardiology Update 2014

Author
1. Chugh Sanjay
2. Chugh Yashasvi
ISBN
9789351526186
DOI
10.5005/jp/books/12415_65
Edition
1/e
Publishing Year
2015
Pages
10
Author Affiliations
1. AHI (Artemis Health Institute) Gurgaon, Haryana, India, Institute of Heart and Vascular diseases, Jaipur Golden Hospital, New Delhi, India
2. Internal Medicine Jacobi Medical Center Albert Einstein College of Medicine, New York, USA, Jacobi Medical Center, Albert Einstein College of Medicine, Bronx, New York, USA, Minneapolis Heart Institute, Abbott North Western Hospital, Minneapolis, MN, USA
Chapter keywords
Transradial access, RA spasm, catheters, coronary, arterial anomalies, artery spasm, fluoroscopy, subclavian, aortic variants, aorta, activated partial thromboplastin, coronary artery bypass graft, left internal mammary artery, radial angioplasty

Abstract

Transradial access (TRA) carries the merits of decreased access site complications and major bleeding; lower costs and earlier patient ambulation. In this chapter, the issue of a scientific approach toward overcoming the learning curve, enhancing success while reducing both, procedure and fluoroscopy time, as well as patient discomfort and access artery spasm is discussed. Transradial procedure failure occurs commonly because of access (puncture) related difficulties, RA spasm and an inability to advance guide catheters to the ascending aorta and hence challenges like Access Artery Spasm, Arterial Anomalies, Hooking the Coronary, Puncture of Access Artery are discussed and tips to overcome them are provided. With judicious use of preprocedure ultrasound, the biggest and straightest RA or UA can be used for access to minimize spasm, fluoroscopy time and patient discomfort, while enhancing success.

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