Transradial Approach for Left Ventricular Endomyocardial Biopsy
Tawfiq Choudhury1, Tim G Schäufele2, Shahar Lavi1
1Interventional Cardiology Laboratories, London Health Sciences Centre, London, Ontario, Canada.
The Canadian Journal of Cardiology
|August 7, 2018
Summary
Transradial left ventricular endomyocardial biopsy (LV-EMB) is safe and feasible, achieving a 99% success rate. This approach offers a promising alternative to traditional femoral access for diagnosing cardiac conditions affecting the left ventricle.
Area of Science:
- Cardiology
- Interventional Cardiology
- Cardiac Biopsy
Background:
- Left ventricular endomyocardial biopsy (LV-EMB) offers higher diagnostic yield than right ventricular EMB for LV-specific conditions.
- LV-EMB is underutilized compared to RV-EMB, often performed via femoral artery despite radial approach prevalence in other procedures.
Purpose of the Study:
- To evaluate the safety and feasibility of performing LV-EMB using a transradial approach.
- To assess the procedural success rate and complication profile of transradial LV-EMB in a multicenter registry.
Main Methods:
- A multicenter registry included 102 patients undergoing transradial LV-EMB.
- Data collected included clinical characteristics, procedural details, safety, and feasibility metrics.
- Sheathless guide catheters were utilized in a significant portion of procedures.
Main Results:
- Successful transradial LV-EMB was achieved in 99% of patients (101/102).
- Radial artery spasm occurred in 12% of patients, with only one conversion to femoral access.
- No access site-related or major complications (e.g., tamponade, death) were reported.
Conclusions:
- Transradial LV-EMB demonstrates a high procedural success rate and an excellent safety profile.
- The findings suggest transradial access is a viable option for LV-EMB.
- Further comparative studies are recommended to promote wider adoption of the transradial route.
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