Ricardo Lluberas 2012-08-09
Allen’s test may not be necessary to select patients eligible for radial access
Original title: Trans-Radial Coronary Catheterization and Intervention Across the Whole Spectrum of Allen’s test Results. Reference: Marco Valgimigli et al. J Am Coll Cardiol. 2014. Epub ahead of print. Radial access is associated with a chance of occlusion of the vessel in between 0.8 % and 30 % according to different series. Given this fact, the Allen...
The higher the bleeding risk, the greater the benefit of radial access in terms of mortality
Original title: Baseline bleeding risk and arterial access site practice in relation to procedural outcomes after percutaneous coronary intervention. Presenter: Mamas A. Mamas et al. J Am Coll Cardiol. 2014;64:1554-1564. The transradial approach has been associated with reduced access site related bleeding complications as well as a reduced mortality in the context of PCI. It seems...
Coronary angioplasty via radial access using 4 Fr introducer. Minimally invasive to the extreme.
Original title: Comparison of frequency of Radial Artery Oclusion Alter 4Fr Versus 6Fr Transradial Coronary intervention (from the Novel Angioplasty Using Coronary Accessor Trial). Reference: Satoshi Takesita, et al. Am J Cardiol 2014;113:1986-89) Since Andreas Gruentzig performed the first angioplasty, technological development has improved devices and radial access becomes more common. This procedure reduces complications, mainly bleeding. However,...
The radial access is a viable alternative in infarction complicated with cardiogenic shock
Original title: Arterial access site utilization in cardiogenic shock in the United Kingdom: Is radial access feasible? Reference: Mamas A. Mamas, et al. Am Heart J 2014;167:900-08 Cardiogenic shock in the context of acute myocardial infarction is associated with high mortality, and represents approximately 10% of major bleeding complications. Radial Access reduces mortality mainly by reducing bleeding; however,...
Decreased bleeding with radial access leaves little to bivalirudin for additional benefit
Original title: Bivalirudin or heparin in primary angioplasty performed through the transradial approach: results from a multicentre registry. Reference: Sciahbasi A et al. Eur Heart J: Acute Cardiovasc Care. Epub ahead of print. Bivalirudin benefit has been demonstrated in terms of bleeding; however when primary angioplasty is performed by radial access this information is not clear. To get...
Transradial access plus bivalirudin, the best combination to reduce bleeding
Original title: Comparison of bivalirudin and radial access across a spectrum of preprocedural risk of bleeding in percutaneous coronary intervention: Analysis from the National Cardiovascular Data Registry. Reference: Baklanov DV et al. Circ Cardiovasc Interv. 2013, article in press. Bleeding complications are clearly associated to mortality increase and two of the current best strategies to reduce bleeding are...
TAVR: Should Transradial Approach be the Second Access Site?
Courtesy of Dr. Carlos Fava. One of the major challenges we interventional cardiologists still face is access management. Reduced device diameter and improved transcatheter closure, together with increased operator experience, have significantly reduced vascular complications. However, we shouldn’t lose sight of the secondary access, usually transfemoral, generally used in case of primary access site related...
MATRIX: Transradial vs. Femoral Access in Non-ST Elevation AMI
Original Title: Radial versus femoral access in patients with acute coronary syndromes with or without ST-segment elevation. Presenter: Bernardo Cortese. The MATRIX study showed that the transradial access is associated with a reduction of combined events, death, infarction, stroke and bleeding, compared to femoral access, in ACS patients. The goal of this sub-analyzis was...
Increase in Femoral Access Complications in the Transradial Era
Original Title: The Benefits Conferred by Radial Access for Cardiac Catheterization Are Offset by a Paradoxical Increase in the Rate of Vascular Access Site Complications with Femoral Access: The Campeau Radial Paradox. Reference: Lorenzo Azzalini et al. J Am Coll Cardiol Intv. 2015, ONLINE FIRST. The aim of this study was to assess whether the benefit of the radial access...