Percutaneous brachial coronary angioplasty utilizing a standard side arm sheath introducer system

A percutaneous approach via the brachial artery for coronary angioplasty is described. The technique employs a standard side arm sheath introducer system routinely intended for the femoral artery. Initial experience in ten cases shows this to be a relatively easy and safe alternative to conventional brachial arteriotomy, with some distinct advantages. It is less time consuming, permits the use of a variety of standard preformed guiding catheters, is associated with less patient discomfort, and the sheaths may be left in place for many hours if the angioplasty is complicated and/or long-term anticoagulation is desirable. Complications were limited to the female patients in this series. This technique is most suited to those operators who employ the brachial approach infrequently and only out of necessity in patients with severe peripheral vascular disease.