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Radial access for concomitant coronary, subclavian and renal artery angioplasty: one case report
Salem Abdessalem1, Sajed Mjadlah, Sami Mourali
1Service des Explorations Fonctionnelles et de Réanimation Cardiologiques, Hôpital la Rabta, Tunis, Tunisie.
Insights
The radial artery approach is a safe and effective option for combined coronary and peripheral angioplasty procedures. This case demonstrates successful stenting of the renal artery, subclavian artery, and LAD via the radial route.
Area of Science:
- Interventional Cardiology
- Vascular Surgery
Background:
- Combined percutaneous transluminal angioplasty (PTA) of coronary and peripheral arteries is increasingly common.
- Access site complications, particularly with femoral or brachial approaches, significantly impact patient outcomes.
- Radial artery access, a proven safe alternative for coronary interventions, shows promise for peripheral PTA due to device advancements.
Observation:
- A 56-year-old woman presented with multivessel coronary artery disease, significant left subclavian artery (SCA) stenosis, and bilateral renal artery stenoses.
- The patient had severe resistant hypertension, necessitating intervention prior to coronary bypass surgery.
- A triple angioplasty involving the left renal artery, SCA, and left anterior descending (LAD) coronary artery was performed.
Findings:
- Successful stenting of the left renal artery, SCA, and LAD was achieved in a single procedure.
- The entire intervention was performed using the left radial artery as the access site.
- No immediate access site complications were reported.
Implications:
- Radial artery access appears suitable and safe for complex, combined percutaneous transluminal angioplasty involving both coronary and peripheral vessels.
- This approach may offer a less complicated alternative to traditional access sites for extensive interventions.
- Further prospective clinical trials are needed to validate the safety and efficacy of radial access for combined procedures.
Background:
Concomitant coronary and peripheral angioplasty is a more frequently reported situation. Patient's outcome is significantly conditioned by access site complications especially in femoral and brachial approaches. The radial artery access is a safe and a well established alternative in coronary interventions and could be suitable for many peripheral angioplasty cases, thanks to devices enhancement.
Aim:
Report a new case.
Case Description:
We report the case of a 56-year-old woman with multivessel coronary artery disease, significant left subclavian (SCA) and bilateral renal arteries stenoses. Because of a severe resistant hypertension and prior to scheduled coronary bypass surgery a triple angioplasty of left renal artery, SCA, and left anterior descending (LAD) was attempted. Stenting of the three sites was successful in the same procedure through the left radial artery route.
Conclusion:
Radial artery access in peripheral, combined and complex percutaneous transluminal angioplasty seems to be suitable and safe. However, prospective clinical trials are still lacking.
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