RadialFirst in CHIP and Cardiogenic Shock

Rhian E Davies; Kathleen E Kearney; James M McCabe

doi:10.1016/j.iccl.2019.08.006

RadialFirst in CHIP and Cardiogenic Shock

Interv Cardiol Clin. 2020 Jan;9(1):41-52. doi: 10.1016/j.iccl.2019.08.006. Epub 2019 Oct 21.

Authors

Rhian E Davies¹, Kathleen E Kearney¹, James M McCabe²

Affiliations

¹ Division of Cardiology, University of Washington, 1959 Northeast Pacific Street Box 356422, Seattle, WA 98195, USA.
² Division of Cardiology, University of Washington, 1959 Northeast Pacific Street Box 356422, Seattle, WA 98195, USA. Electronic address: jmmccabe@uw.edu.

PMID: 31733740
DOI: 10.1016/j.iccl.2019.08.006

Abstract

This article highlights the advantages and disadvantages of transradial arterial (TRA) access for a variety of presentations including acute coronary syndromes; cardiogenic shock; unprotected left main, heavily calcified coronaries; bifurcations; and chronic total occlusions. It includes techniques for overcoming challenges of using TRA access, including spasm and the need for larger bore guides. In addition, the authors review the use of ultrasound for access, percutaneous hemodynamic support via axillary approach, and tips and tricks to performing right heart catheterizations from the antecubital vein.

Keywords: Alternative access; Antecubital vein; Cardiogenic shock; Large bore access; Transradial arterial access; Ultrasound guidance access.

Publication types

Review

MeSH terms

Cardiac Catheterization / methods*
Humans
Percutaneous Coronary Intervention / methods*
Radial Artery*
Shock, Cardiogenic / therapy*