BOOK
Transradial Access: Techniques for Diagnostic Angiography and Percutaneous Intervention
(2013)
Additional Information
Book Details
Abstract
Transradial Access: Techniques for Diagnostic Angiography and Percutaneous Intervention offers a single source for both novice and experienced interventional cardiologists for safely and effectively performing transradial catheterization procedures. First described in 1989, the transradial approach for coronary angiography and percutaneous interventions has seen a constant and progressive increase around the world as a result of significantly reduced procedural complications, shorter hospital stays, increased patient satisfaction, and lower associated costs compared with the transfemoral approach.
Yet despite its apparent benefits, adoption of this technique in the United States has been slow, largely due to the increased technical aspects of entering a smaller artery, accessing the central circulation and engaging the coronary arteries from this approach. In addition, until recently the technique was not routinely taught in the majority of training programs. This book flattens that learning curve by highlighting the technical aspects of transradial diagnostic and interventional procedures, and includes detailed discussion of:
Normal vascular anatomy of the hand and arm
Indications and contraindications for transradial access procedures
Patient and catheter selection
Tips and tricks for both beginner and advanced operators
Procedural pitfalls and potential complications
Techniques are demonstrated in detail using both still images and video. Whether you are an experienced transfemoral operator who wants to refine and expand your technique or a new transradial operator looking to master the technique, this comprehensive text holds the key to mastering this revolutionary procedure.
Table of Contents
| Section Title | Page | Action | Price |
|---|---|---|---|
| Cover\r | Cover | ||
| Transradial Access | iii | ||
| Contents | v | ||
| Contributors | vii | ||
| Foreword | xi | ||
| Abbreviations | xiii | ||
| Chapter 1: Introduction | 1 | ||
| HOW TO USE THIS BOOK | 2 | ||
| REFERENCES | 5 | ||
| Chapter 2: Rationale for Transradial Access | 7 | ||
| INTRODUCTION | 7 | ||
| DEFINING BLEEDING AND VASCULAR COMPLICATIONS | 8 | ||
| INCIDENCE OF ACCESS SITE BLEEDING AND VASCULAR COMPLICATIONS | 8 | ||
| NON-ACCESS SITE-RELATED BLEEDING | 10 | ||
| ASSOCIATION BETWEEN BLEEDING AND OUTCOMES | 12 | ||
| EFFECT OF TRANSRADIAL ACCESS ON BLEEDING AND CARDIOVASCULAR OUTCOMES | 13 | ||
| TRANSRADIAL APPROACH IN STEMI | 16 | ||
| NONCLINICAL BENEFITS OF TRANSRADIAL ACCESS | 16 | ||
| SUMMARY | 18 | ||
| REFERENCES | 19 | ||
| Chapter 3: Vascular Anatomy of the Arm and Hand | 21 | ||
| INTRODUCTION | 21 | ||
| ANATOMIC BACKGROUND | 21 | ||
| VASCULAR ANOMALIES | 25 | ||
| VESSEL DIMENSION CONSIDERATIONS | 28 | ||
| UNDERSTANDING AND ASSESSING THE VASCULAR ANATOMY OF THE HAND | 30 | ||
| UPPER EXTREMITY COMPARTMENTS: BASIC ANATOMY AND POTENTIAL ROLE IN COMPLICATIONS | 34 | ||
| SUMMARY | 36 | ||
| REFERENCES | 36 | ||
| Chapter 4: Preoperative Evaluation of the Potential Patient for Transradial Access | 39 | ||
| PATIENT SELECTION FOR THE TRANSRADIAL ACCESS | 39 | ||
| SUMMARY | 45 | ||
| REFERENCES | 45 | ||
| Chapter 5: Obtaining Access | 47 | ||
| PREPARATION AND POSITIONING OF THE PATIENT | 47 | ||
| PREVENTING SPASM AND HYPOTENSION | 52 | ||
| ACCESSING THE CENTRAL AORTA FROM THE RIGHT RADIAL | 52 | ||
| ACCESSING THE ASCENDING AORTA FROM THE LEFT RADIAL | 53 | ||
| SUMMARY | 53 | ||
| VIDEO LEGENDS | 53 | ||
| Chapter 6: Closure and Hemostasis after Transradial Access | 55 | ||
| HEMOSTASIS | 55 | ||
| RADIAL ARTERY OCCLUSION | 55 | ||
| PATENT HEMOSTASIS TECHNIQUE | 56 | ||
| PREDISCHARGE CARE | 58 | ||
| SUMMARY | 58 | ||
| REFERENCES | 60 | ||
| Chapter 7: Basic Catheter Techniques for Diagnostic Angiography and PCI | 61 | ||
| INTRODUCTION | 61 | ||
| PATIENT SELECTION | 61 | ||
| RIGHT VERSUS LEFT RADIAL ACCESS | 62 | ||
| GENERAL CATHETER TECHNIQUES | 62 | ||
| DIAGNOSTIC CORONARY ANGIOGRAPHY | 63 | ||
| CATHETERS USED FOR PCI | 67 | ||
| TIPS TO IMPROVE TRANSRADIAL PCI SUCCESS | 70 | ||
| SUMMARY | 73 | ||
| REFERENCES | 73 | ||
| VIDEO LEGENDS | 74 | ||
| Chapter 8: Sheathless Transradial Intervention | 75 | ||
| INTRODUCTION | 75 | ||
| DEVICES AND TECHNIQUES | 75 | ||
| CASE EXAMPLE | 77 | ||
| SUMMARY | 78 | ||
| REFERENCES | 78 | ||
| Chapter 9: Transradial Access and Outpatient PCI:\rState-of-the-Art and Persisting Challenges | 79 | ||
| INTRODUCTION | 79 | ||
| ISCHEMIC RISK IS NEGLIGIBLE IN CONTEMPORARY PCI PRACTICE | 80 | ||
| TRANSRADIAL ACCESS: CONSISTENTLY LOWER RISK OF BLEEDING AND VASCULAR COMPLICATIONS | 80 | ||
| SAME-DAY-DISCHARGE PCI: BUILDING THE EVIDENCE IN EARLY DAYS | 81 | ||
| OUTPATIENT PCI IN THE ERA OF CORONARY STENTS | 83 | ||
| TRADE-OFF BETWEEN ISCHEMIC AND BLEEDING RISK AND OUTPATIENT PCI | 84 | ||
| EVIDENCE FROM RANDOMIZED TRIAL—THE EASY STUDY: THE BUILDING BLOCK FOR A STRUCTURED OUTPATIENT CLINICAL PROGRAM | 85 | ||
| CURRENT GUIDELINES FOR OUTPATIENT PCI PRACTICE | 88 | ||
| SETTING UP OUTPATIENT PCI PROGRAM | 88 | ||
| SUMMARY | 92 | ||
| REFERENCES | 92 | ||
| Chapter 10: Transradial Access for PCI in Acute Myocardial Infarction | 95 | ||
| INTRODUCTION | 95 | ||
| TRENDS IN ACS MANAGEMENT | 96 | ||
| PROCEDURAL ASPECTS | 96 | ||
| BLEEDING IN ACS | 98 | ||
| STUDIES COMPARING RADIAL WITH FEMORAL ACCESS | 104 | ||
| GROUPS THAT MAY FURTHER BENEFIT FROM RADIAL ACCESS | 113 | ||
| SUMMARY | 115 | ||
| REFERENCES | 115 | ||
| Chapter 11: Transradial Approach to Peripheral Interventions | 121 | ||
| INTRODUCTION | 121 | ||
| ANATOMY | 121 | ||
| GENERAL TECHNICAL CONSIDERATIONS | 122 | ||
| SUBCLAVIAN ARTERY ANGIOPLASTY AND STENTING | 123 | ||
| TRANSRADIAL STENTING OF THE CAROTID ARTERIES | 124 | ||
| TECHNIQUE OF THE CAROTID ARTERY STENTING | 124 | ||
| TRANSRADIAL INTERVENTIONS FOR RENAL ARTERY STENOSIS | 125 | ||
| TRANSRADIAL INTERVENTION OF THE ILIAC ARTERY STENOSIS | 127 | ||
| ADVANTAGES OF TRANSRADIAL APPROACH FOR ILIAC ANGIOPLASTY | 127 | ||
| ANATOMICAL CONSIDERATIONS | 127 | ||
| SAFETY AND EFFICACY OF TRANSRADIAL ILIAC INTERVENTIONS | 128 | ||
| SUMMARY | 128 | ||
| REFERENCES | 128 | ||
| Chapter 12: Right Heart Catheterization and Transradial Access | 131 | ||
| BACKGROUND | 131 | ||
| PERIPHERAL VENOUS ANATOMY AND PHYSIOLOGY | 132 | ||
| PRACTICAL APPROACH TO CENTRAL VENOUS ACCESS FROM THE FOREARM | 133 | ||
| VASCULAR SHEATH PLACEMENT IN THE CATHETERIZATION LABORATORY | 134 | ||
| PASSAGE TO THE CENTRAL VENOUS AND PULMONARY CIRCULATION | 135 | ||
| POSTPROCEDURAL ACCESS SITE MANAGEMENT | 135 | ||
| OVERCOMING POTENTIAL CHALLENGES | 136 | ||
| ADVANCE TECHNIQUES | 139 | ||
| SUMMARY | 139 | ||
| REFERENCES | 139 | ||
| Chapter 13: The Learning Curve for Transradial Access | 141 | ||
| INTRODUCTION | 141 | ||
| HOW TO ASSESS THE LEARNING CURVE | 142 | ||
| WHAT IS THE LEARNING CURVE OF THE RADIAL APPROACH? | 142 | ||
| WHAT DOES THE LEARNING PERIOD INVOLVE? | 147 | ||
| HOW TO BEST TEACH AND LEARN THE TRANSRADIAL APPROACH | 149 | ||
| SUMMARY | 151 | ||
| REFERENCES | 151 | ||
| Chapter 14: Transradial Arterial Access: Economic Considerations | 155 | ||
| ECONOMIC BENEFIT OF TRA RELATED TO REDUCED COMPLICATIONS | 155 | ||
| ECONOMIC IMPACT OF POLICY CHANGES IN THE HEALTH CARE SYSTEM | 158 | ||
| ECONOMIC BENEFITS OF TRA RELATED TO RECOVERY AND MOBILITY | 158 | ||
| OTHER POTENTIAL ECONOMIC BENEFITS | 160 | ||
| NEGATIVE ECONOMIC CONSIDERATIONS RELATED TO TRA | 160 | ||
| SUMMARY | 160 | ||
| REFERENCES | 161 | ||
| Chapter 15: Tips and Tricks for Transradial Access | 165 | ||
| BACKGROUND | 165 | ||
| ISSUES RELATED TO RADIAL AND BRACHIAL REGIONS | 165 | ||
| ISSUES RELATED TO SUBCLAVIAN, INNOMINATE, AND AORTIC ARCH REGIONS | 172 | ||
| SUMMARY | 178 | ||
| REFERENCES | 178 | ||
| Chapter 16: Complications of Transradial Access | 181 | ||
| SPECTRUM AND INCIDENCE OF COMPLICATIONS | 181 | ||
| COMMON COMPLICATIONS | 181 | ||
| RARE COMPLICATIONS | 185 | ||
| SUMMARY | 188 | ||
| REFERENCES | 190 | ||
| VIDEO LEGENDS | 191 | ||
| Chapter 17: How to Start a Transradial Program at Your Hospital | 193 | ||
| INTRODUCTION | 193 | ||
| SUMMARY | 197 | ||
| REFERENCES | 198 | ||
| Appendix | 201 | ||
| Index | 203 | ||
| A | 203 | ||
| B | 203 | ||
| C | 204 | ||
| D | 204 | ||
| E | 204 | ||
| F | 205 | ||
| G | 205 | ||
| H | 205 | ||
| I | 205 | ||
| J | 205 | ||
| K | 205 | ||
| L | 205 | ||
| M | 206 | ||
| N | 206 | ||
| O | 206 | ||
| P | 206 | ||
| Q | 207 | ||
| R | 207 | ||
| S | 208 | ||
| T | 208 | ||
| U | 209 | ||
| V | 209 | ||
| W | 209 | ||
| X | 209 | ||
| Back Cover | 211 |