A new manoeuvre for overcoming extreme brachiocephalic artery tortuosity in radial coronary angiography
نویسندگان
چکیده
Corresponding author: Kudret Keskin MD, Cardiology Department, Medicana Hospitals Bahçelievler, Eski Londra Asfaltı Haznedar, 34100 Istanbul, Turkey, phone: +905054015847, e-mail: [email protected] Received: 2.01.2014, accepted: 7.01.2014. The radial approach has a class II recommendation in percutaneous coronary interventions for decreasing access site complications [1]. Radial coronary intervention is being used more in recent years. The radial approach has some limitations that are not seen in the femoral approach. Severe subclavian artery tortuosity and distal origin of the innominate artery result in a decreased forward force and increased friction during the progression of the wire or guide in the ascending aorta, which usually resolves with the use of a hydrophilic wire combined with deep breathing [2]. However, when subclavian artery and severe brachiocephalic artery tortuosity combines, the cannulation of the coronary arteries may be difficult. A 75-year-old male patient had moderate-degreesubclavian and severe brachiocephalic tortuosity that allowed left coronary cannulation and angiogram with a Judkins L 3.5 diagnostic catheter from the right radial approach (Figures 1 A, B). However, it was impossible to advance the right Judkins catheter down to the right sinus Valsalva and rotate it with even stiffer wires with
منابع مشابه
Usefulness of a Prominently Projected Aortic Arch on Chest Radiograph to Predict Severe Tortuosity of the Right Subclavian or Brachiocephalic Artery in Patients >44 Years of Age Undergoing Coronary Angiography with a Right Radial Artery Approach
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عنوان ژورنال:
دوره 10 شماره
صفحات -
تاریخ انتشار 2014