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Slender PCI via Transradial Approach

  • Ferdinand KiemeneijEmail author
  • Shigeru Saito
  • Wei Liu
Chapter

Abstract

The less invasive radial access for percutaneous coronary intervention (PCI) has gained the favour of interventionists for its advantage in reducing access site complications, improving patient comfort and reducing mortality. However, due to the smaller diameters of radial artery, the catheter size is therefore too large for some patients, which makes this technique painful, cumbersome and sometimes unsafe, also sets a limitation for complex PCI. In addition, radial artery occlusion (RAO) is more common when guides are large in comparison to the radial artery. This led to the development of series of downsized equipment and corresponding techniques to overcome this problem, which was so called “Slender” for this new approach.

Keywords

Percutaneous Coronary Intervention Radial Artery Guide Wire Sheath Introducer Interventional Device 
These keywords were added by machine and not by the authors. This process is experimental and the keywords may be updated as the learning algorithm improves.

Supplementary material

Video 22.1

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Video 22.2

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Video 22.2

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References

  1. 1.
    Chase AJ, Fretz EB, Warburton WP, et al. Association of the arterial access site at angioplasty with transfusion and mortality: the M.O.R.T.A.L study (Mortality benefit Of Reduced Transfusion after percutaneous coronary intervention via the Arm or Leg). Heart. 2008;94:1019–25.CrossRefPubMedGoogle Scholar
  2. 2.
    Jolly SS, Yusuf S, Cairns J, et al. Radial versus femoral access for coronary angiography and intervention in patients with acute coronary syndromes (RIVAL): a randomised, parallel group, multicentre trial. Lancet. 2011;377:1409–20.CrossRefPubMedGoogle Scholar
  3. 3.
    Hamon M, Pristipino C, Di Mario C, et al. Consensus document on the radial approach in percutaneous cardiovascular interventions: position paper by the European Association of Percutaneous Cardiovascular Interventions and Working Groups on Acute Cardiac Care** and Thrombosis of the European Society of Cardiology. EuroIntervention J EuroPCR Collaboration Working Group Interv Cardiol Eur Soc Cardiol. 2013;8:1242–51.CrossRefGoogle Scholar
  4. 4.
    Rao SV, Tremmel JA, Gilchrist IC, et al. Best practices for transradial angiography and intervention: a consensus statement from the society for cardiovascular angiography and intervention’s transradial working group. Catheter Cardiovasc Interv Off J Soc Cardiac Angiography Interv. 2014;83:228–36.CrossRefGoogle Scholar
  5. 5.
    Saito S, Ikei H, Hosokawa G, Tanaka S. Influence of the ratio between radial artery inner diameter and sheath outer diameter on radial artery flow after transradial coronary intervention. Catheter Cardiovasc Interv Off J Soc Cardiac Angiography Interv. 1999;46:173–8.CrossRefGoogle Scholar
  6. 6.
    Kiemeneij F, Yoshimachi F, Matsukage T, et al. Focus on maximal miniaturisation of transradial coronary access materials and techniques by the Slender Club Japan and Europe: an overview and classification. EuroIntervention J EuroPCR Collaboration Working Group Interv Cardiol Eur Soc Cardiol. 2015;10:1178–86.CrossRefGoogle Scholar
  7. 7.
    Amoroso G, van Dullemen A, Westgeest P, van Duinen M. “Virtual” 3 Fr transradial coronary stenting with the 5 Fr Meito Masamune sheathless guiding catheter: feasibility and safety in an outpatient setting. J Invasive Cardiol. 2016;28:109–14.PubMedGoogle Scholar
  8. 8.
    Tonomura D, Shimada Y, Yano K, et al. Feasibility and safety of a virtual 3-Fr sheathless-guiding system for percutaneous coronary intervention. Catheter Cardiovasc Interv Off J Soc Cardiac Angiography Interv. 2014;84:426–35.CrossRefGoogle Scholar
  9. 9.
    Takeshita S, Asano H, Hata T, et al. Comparison of frequency of radial artery occlusion after 4Fr versus 6Fr transradial coronary intervention (from the Novel Angioplasty USIng Coronary Accessor Trial). Am J Cardiol. 2014;113:1986–9.CrossRefPubMedGoogle Scholar
  10. 10.
    Hamood H, Makhoul N, Grenadir E, Kusniec F, Rosenschein U. Anchor wire technique improves device deliverability during PCI of CTOs and other complex subsets. Acute Card Care. 2006;8:139–42.CrossRefPubMedGoogle Scholar
  11. 11.
    Fujita S, Tamai H, Kyo E, et al. New technique for superior guiding catheter support during advancement of a balloon in coronary angioplasty: the anchor technique. Catheter Cardiovasc Interv Off J Soc Cardiac Angiography Interv. 2003;59:482–8.CrossRefGoogle Scholar
  12. 12.
    Takahashi S, Saito S, Tanaka S, et al. New method to increase a backup support of a 6 French guiding coronary catheter. Catheter Cardiovasc Interv Off J Soc Cardiac Angiography Interv. 2004;63:452–6.CrossRefGoogle Scholar

Copyright information

© Springer Science+Business Media Dordrecht 2017

Authors and Affiliations

  1. 1.Department of CardiologyTergooi HospitalBlaricumThe Netherlands
  2. 2.Division of Cardiology & Catheterization LaboratoriesShonan Kamakura General HospitalKamakuraJapan
  3. 3.Department of CardiologyBeijing Anzhen Hospital, Capital Medical UniversityBeijingChina

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