Technique of PTCA by the Brachial Approach: Practical Considerations and Comparison with the Femoral Artery Method

Abstract

The development of a double-lumen dilatation catheter modified the original coaxial catheter technique and permitted successful dilatation of peripheral arterial stenoses [1]. The miniaturization of this double-lumen catheter permitted the dilatation of stenoses in the epicardial coronary arterial system. However, a delivery system was necessary to guide these coronary dilatation catheters into the coronary artery [2]. Initially, preshaped guide catheters were percutaneously introduced through the femoral artery to engage the coronary ostium and thereby allow passage of the dilatation catheter into the coronary artery. The brachial artery guide catheter was developed to permit introduction of a single, multipurpose guide catheter which would allow intubation of either coronary ostium or of the saphenous vein graft ostium for the performance of single or multiple transluminal coronary angioplasties [3]. Patient selection and the brachial technique with its advantages and disadvantages are discussed.