A technique to access difficult to find upper extremity veins for right heart catheterization: the levogram technique

Area of Science:

• Cardiology
• Vascular Surgery
• Interventional Radiology

Background:

• Right heart catheterization (RHC) is a crucial diagnostic procedure.
• Femoral venous access is the traditional approach for RHC, but carries risks.
• Upper extremity venous access offers a potentially safer alternative.

Observation:

• Transradial catheterization is commonly performed for cardiac procedures.
• Deep veins in the upper extremity can be accessed during transradial procedures.
• Levophase contrast venography can visualize these deep veins.

Findings:

• A technique is described to access deep upper extremity veins during transradial catheterization using levophase contrast venography.
• This method does not require additional equipment, staff, or specialized training.
• It utilizes standard cardiac catheterization laboratory skills and equipment.

Implications:

• This technique enhances the safety profile of RHC by utilizing a preferred venous access site.
• It simplifies the procedural workflow for accessing deep upper extremity veins.
• This approach may become a valuable alternative for RHC and other venous access procedures.