radial

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...

The radial approach for PCI reduces mortality

Original title: Radial Versus Femoral Access for Primary Percutaneous Interventions in ST-Segment Elevation Myocardial Infarction Patients. A Meta-Analysis of Randomized Controlled Trials. Reference: Wassef Karrowni et al. J Am Coll Cardiol Intv 2013;6:814–23. Bleeding is the most frequent in-hospital complication of PCI, and it is clearly associated with adverse events that include death.   STEMI patients require emergency...

Full conversion from transfemoral to transradial: similar success rate and far less complications.

Original title: Full conversion from transfemoral to transradial approach for percutaneous coronary interventions results in a similar success rate and a rapid reduction of in-hospital cardiac and vascular major events. Reference: Vincent Dangoisse et al. EuroIntervention 2013;9:345-352.   Although the transfemoral approach has clear disadvantages when it comes to bleeding complications, it continues to be the preferred approach...

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...

Transradial Angioplasty: do we need more proof to adopt it for good?

Original title: Influence of Arterial Access Site Selection on Outcomes in Primary Percutaneous Coronary Intervention. Are the Results of Randomized Trials Achievable in Clinical Practice? Reference: Mamas A. Mamas et al. J Am Coll Cardiol Intv 2013. Article in press. Antithrombotic therapy has improved the prognosis of patients with acute ST-segment elevation myocardial infarction by reducing ischemic events....

A moderate dose of midazolam and fentanyl is effective in reducing radial spasms 

Original title: Moderate Procedural Sedation and Opioid Analgesia During Transradial Coronary Interventions to Prevent Spasm. A Prospective Randomized Study. Reference: Spyridon Deftereos et al. J Am Coll Cardiol Intv 2013;6:267–73. The trans-radial approach has become the preferred diagnostic and therapeutic study for evidence of minor vascular complications, shorter hospital stays, less blood loss and better outcomes in acute...

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