Dionysios Gatzopoulos, Aggeliki Rigatou, Eleftherios Kontopodis, Ioannis Tsiafoutis, Maria Agelaki, Efstathios Lazaris, Konstantinos Kintis, Sotirios Patsilinakos, Michael Koutouzis. Alternative access site choice after initial radial access site failure for coronary angiography and intervention[J]. Journal of Geriatric Cardiology, 2018, 15(9): 585-590. DOI: 10.11909/j.issn.1671-5411.2018.09.001
Citation: Dionysios Gatzopoulos, Aggeliki Rigatou, Eleftherios Kontopodis, Ioannis Tsiafoutis, Maria Agelaki, Efstathios Lazaris, Konstantinos Kintis, Sotirios Patsilinakos, Michael Koutouzis. Alternative access site choice after initial radial access site failure for coronary angiography and intervention[J]. Journal of Geriatric Cardiology, 2018, 15(9): 585-590. DOI: 10.11909/j.issn.1671-5411.2018.09.001

Alternative access site choice after initial radial access site failure for coronary angiography and intervention

  • Background Transradial access for coronary catheterization is more technically challenging compared to the traditional transfemoral approach and radial access failure is quite common. The aim of this study is to describe the additional steps after initial radial access site failure in a high specialized forearm approach center. Methods A retrospective evaluation of all coronary catheterizations performed in our Department between January 2016 and December 2016 was performed, with focus on arterial access. Results One thousand three hundred forty six procedures were evaluated. The initial access site used was right radial 1173 procedures (87.1%), left radial 120 procedures (8.9%), right ulnar 7 procedures (0.5%), left ulnar 40 procedures (2.9%) and femoral approach 6 procedures (0.4%). Radial artery cannulation failure was observed in 37 procedures (2.9% of 1293 procedures with initial radial approach). Failure of procedure completion after successful radial sheath insertion was observed in 46 procedures (3.6%). The alternative access site after initial radial approach failure was contralateral radial 43 procedures (51.8%), ipsilateral ulnar 22 procedures (26.5%), contralateral ulnar 12 patients (14.5%) and femoral approach 6 procedures (7.2%). Conclusion Forearm arteries can be used as alternative access site after initial radial approach failure in order to reduce the use of femoral approach during cardiac catheterization.
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