We presented a paper on our innovative technique at the AMERICAN COLLEGE OF CARDIOLOGY ANNUAL SCIENTIFIC MEETING published in the Journal of American College of Cardiology which has already been cited by 7 other scientific publications.
Angiography and angioplasty via patient’s hand has been a revolution in Cardiology .
Angiography is a test to diagnose blockages in heart arteries. Angioplasty is the procedure to open the blocked heart arteries.
Risk of bleeding and risk to life with angioplasty have both shrunk with the use of radial technology of performing the procedures through patient’s hand; over and above the comfort to patients as they can sit up and eat and walk to the toilet soon after the procedure.
But in the individuals with smaller body size, as in women this can be a challenge as the radial artery or the vessel through which the tubes travel to the heart arteries for angiography or for angioplasty are proportionately smaller.
We innovated to overcome this challenge. Our paper describes our innovative technique.to overcome the same, so that the benefit of radials can be offered to even the individuals of smaller body size including women.
Publication :
Overcoming The Challenge Of Transradial Interventions In Women: Insights From a Color Doppler Study:
Sanjay K Chugh, Yashasvi Chugh, Sunita Chugh
Journal of the American College of Cardiology 64 (11S), B240-B240, 2014
Background:
The use of compression of the other artery [(COOA): ulnar compression for radial access and vice versa], could increase access artery diameter (AAD)(via collateral flow through palmar arch) thus reducing puncture failure in small arteries, which is a major challenge of transradial access in women. We aimed to assess impact of COOA on puncture failures.
Methods:
AADs were measured using pre-procedure ultrasound (PPUAA). COOA (for 5 minutes) was randomly utilized at the time of elective procedures, in 50% patients in whom the single largest AAD was 1.5, 1.6 or 1.7 mm. 1.5 mm arteries were used for coronary angiogram (CAG);≥ 1.6 mm were used for percutaneous coronary intervention (PCI).
Results:
In a total of 1110 patients: 264 females (F), the baseline mean AADs (mm) were larger in males (1.82±0.2 (radial (RA)), 1.78±0.2 (ulnar (UA)) vs 1.71±0.2 (RA), 1.60±0.2 (UA))(p< 0.001). With COOA, the AAD increased by 16.6+ 6%; 14.5±3% &12±4.2% in the 1.5, 1.6 &1. 7mm groups respectively and puncture success was 78% vs 98%(p< 0.001), 88% vs 97.8%(P< 0.001) and 96.7% vs 98.5%(p= 0.06) with and without COOA respectively.
Females more commonly have only one large AA, compared to men. In the 1.5-1.6 mm AAs, the use of COOA reduces puncture failures. Smaller AAs (< 1.7 mm), are associated with higher cross-over, procedure failure & AA occlusion.
View at jacc.org
• Cited by 7 #radialfirst #angioplasty #angiography #radial #women