Because of their smaller physical stature,
arm arteries are smaller in Indians compared to Caucasians.
We overcame the challenge of successfully performing radial angiography and angioplasty in them by performing doppler ultrasound of arm arteries prior to interventional procedures to identify the largest and the straightest access to the patient’s heart via the hand. We thus achieved higher procedural success of nearly100% as well as safety, with virtually no complications.
Our landmark paper, based on our pioneering work was one of the earliest studies, with a large number of patients. It was published in CCI.
It is now established that unlike with procedure via the groin ; A procedure through the hand is safer, with virtually no bleeding complications and is associated with a lower risk of dying.
The patient can sit up , eat and walk to the toilet immediately after a radial procedure.
Publication:
Feasibility and utility of pre-procedure ultrasound imaging of the arm to facilitate transradial coronary diagnostic and interventional procedures (PRIMAFACIE-TRI).
Sanjay Kumar Chugh, Sunita Chugh, Yashasvi Chugh, Sunil V Rao
Catheterization and cardiovascular interventions: official journal of the Society for Cardiac Angiography & Interventions 82 (1), 64-73, 2013
OBJECTIVES:
To assess feasibility and utility of imaging of both arms using ultrasound to facilitate transradial (TR) and transulnar (TU) coronary angiograms (CA) and intervention.
BACKGROUND:
Despite well recognized advantages, transradial approach (TRA) has challenges that reduce procedural success including small arterial size, anatomical variations, and anomalies of radial artery (RA). The utility of routine pre-procedural ultrasound of the arm arteries (PPUAA) in facilitating TRA has not been previously studied.
METHODS:
In this single center registry of consecutive patients undergoing diagnostic and interventional procedures , all patients underwent PPUAA of the right and left radial, ulnar (UA), as well as the brachial arteries (BA) using a linear probe.
RESULTS:
Complete data on radial (mean 1.9 mm (male); 1.7 mm (female)) and ulnar artery size (mean 1.8 mm (male); 1.6 mm (female)) and data on brachial branching anatomy were available in 2,344 patients; The mean time to perform bilateral PPUAA was 6.4 min±1.8 min. Procedure success was 98.7% for CA and 97.5% for percutaneous coronary intervention. Outcomes were better in this cohort compared with 3,781 patients without PPUAA
CONCLUSION:
PPUAA is feasible, requires minimum time, and provides anatomical information that may improve procedure success while reducing patient discomfort, arterial spasm, and fluoroscopy time. read more.. #safetyandhealth #heartattacks #HeartTreatment #cardiologist #angioplasty #angiography #radial #radialfirst