Radial access - be prepared!

Ioannis Stathopoulos1

  • 1Weill Medical College of Cornell University, New York Hospital, Queens, Flushing, New York 11355, USA. jstathopoulos@nyp.org

We present the case of a 46-year-old female patient that experienced recurrent stent thrombosis and underwent attempted primary PCI via the radial artery. Although radial artery cannulation with a 6 Fr sheath and the diagnostic angiography were successfully performed, the PCI could not be achieved because of failure to advance the 6 Fr guide through the radial artery, due to severe angulation of a high take-off radial artery, combined with a proximal radial artery stenosis.

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Assessment of radial pulse01:11

Assessment of radial pulse

Assessment of Radial Pulse
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Assessment of apical radial pulse01:25

Assessment of apical radial pulse

Apical-Radial (A-R) Pulse Assessment
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Pre-Procedural Preparation
Radial System Protection01:23

Radial System Protection

Radial systems employ time-delay overcurrent relays to reduce load interruptions. When a fault occurs, the nearest breaker opens first, while upstream breakers remain closed due to longer delay settings. This approach ensures minimal disruption to the rest of the system.
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Bones of the Upper Limb: Radius01:09

Bones of the Upper Limb: Radius

The radius is longer of the two bones that make up the human antebrachium or forearm. At the proximal end, the radius articulates with the capitulum of the humerus and the radial notch of the ulna to form the elbow joint. At the distal end, the radius articulates with the ulna via the ulnar notch, forming the distal radioulnar joint. Distally, the radius also attaches to the carpal wrist bones (scaphoid and lunate) to form the radiocarpal joint.
The radius has a nail-shaped head, and a short...