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Transradial cardiac catheterization in patients with prior brachial artery cutdown
R P Caputo1, A Simons, A Giambartolomei
1Division of Cardiology, St Joseph's Hospital, Syracuse, New York, USA.
Insights
Transradial cardiac catheterization is safe and effective even in patients with prior ipsilateral brachial cutdown. Careful screening ensures high success rates for this cardiac procedure.
Area of Science:
- Cardiology
- Vascular Surgery
Background:
- Transradial cardiac catheterization is a common procedure.
- The safety of transradial catheterization after ipsilateral brachial cutdown is not well-established.
Purpose of the Study:
- To evaluate the safety and efficacy of transradial cardiac catheterization in patients with a history of ipsilateral brachial cutdown.
Main Methods:
- A consecutive series of 278 patients underwent transradial catheterization.
- Sixty-three patients had a history of ipsilateral brachial cutdown.
- Preprocedural screening included assessment of radial pulse and Allen's test.
Main Results:
- No significant difference in success rates between patients with and without prior brachial cutdown (93.6% vs. 95.3%).
- No periprocedural complications were observed.
- Brachial artery occlusion occurred in only two cases, leading to unsuccessful attempts.
Conclusions:
- Transradial cardiac catheterization is a viable and safe option for patients with prior ipsilateral brachial cutdown.
- Careful preprocedural screening is crucial for successful outcomes.
- This approach offers a high success rate in a majority of patients.
Abstract:
The safety and efficacy of transradial cardiac catheterization in patients with prior ipsilateral brachial cutdown is not known. Using standard techniques we performed transradial catheterization in 278 consecutive patients, of which 63 had prior brachial cutdown. All patients had a strongly palpable radial pulse and a negative Allen's test. Although patients with prior cutdown were older and had a higher incidence of hypertension and prior coronary artery bypass surgery, there was no significant difference in success rates for transradial catheterization (93.6% vs. 95.3%; P = NS). There were no periprocedural complications. Brachial artery occlusion was responsible for only two unsuccessful catheterization attempts. We conclude that, with careful preprocedural screening, ipsilateral transradial cardiac catheterization can be successfully performed in a majority of patients with prior brachial cutdown.