Advertisement

Difficulty Gaining Radial Access

  • Will T. Roberts
  • James Nolan
Chapter

Abstract

Radial artery puncture is often perceived as a daunting challenge to the radial newcomer, however certain techniques exist that can maximise the chances of success. In this chapter we discuss preparation of the patient, emphasising hydration and anxiety reduction measures. The most successful radial puncture techniques are covered, along with guidance on sheath type and size. Once the radial artery has been accessed, traversing tortuous anatomy in the radial artery is also discussed.

Keywords

Radial Puncture Technique Sheath Transfixion Seldinger Cannula Tortuosity 

References

  1. 1.
    Carrillo X, Mauri J, Fernandez-Nofrerias E, Rodriguez-Leor O, Bayes-Genis A. Safety and efficacy of transradial access in coronary angiography: 8-year experience. J Invasive Cardiol. 2012;24:346–51.PubMedGoogle Scholar
  2. 2.
    Pancholy SB, Coppola J, Patel T. Subcutaneous administration of nitroglycerin to facilitate radial artery cannulation. Cathet Cardiovasc Interv. 2006;68:389–91.CrossRefGoogle Scholar
  3. 3.
    Louvard Y, Lefevre T, Morice MC. Radial approach: what about the learning curve? Cathet Cardiovasc Diagn. 1997;42:467–8.CrossRefPubMedGoogle Scholar
  4. 4.
    Pancholy SB, Sanghvi KA, Patel TM. Radial artery access technique evaluation trial: randomized comparison of Seldinger versus modified Seldinger technique for arterial access for transradial catheterization. Catheter Cardiovasc Interv. 2012;80:288–91.CrossRefPubMedGoogle Scholar
  5. 5.
    Rathore S, Stables RH, Pauriah M, Hakeem A, Mills JD, Palmer ND, et al. Impact of length and hydrophilic coating of the introducer sheath on radial artery spasm during transradial coronary intervention: a randomized study. JACC Cardiovasc Interv. 2010;3:475–83.CrossRefPubMedGoogle Scholar
  6. 6.
    Kurisu S, Mitsuba N, Kato Y, Ishibashi K, Dohi Y, Nishioka K, et al. External side-compression of radial artery: a simple technique for successful advancement of guidewires through the radial approach. J Interv Cardiol. 2011;24:397–400.CrossRefPubMedGoogle Scholar
  7. 7.
    Roberts J, Manur R. Ultrasound-guided radial artery access by a non-ultrasound trained interventional cardiologist improved first-attempt success rates and shortened time for successful radial artery cannulation. J Invasive Cardiol. 2013;25(12):676–9.PubMedGoogle Scholar

Copyright information

© Springer-Verlag London 2016

Authors and Affiliations

  1. 1.Department of CardiologyWorcestershire Royal HospitalWorcesterUK
  2. 2.Department of CardiologyUniversity Hospital of North Staffordshire, University Hospital of North Staffordshire NHS TrustStoke-on-TrentUK

Personalised recommendations