Mother-in-Child Assisted Tracking (MiCAT): A Mechanical Technique to Overcome Severe Radial Artery Spasm

Severe radial artery spasm (RAS) and tortuosity may hinder guide catheter advancement and manipulation, requiring the arterial access site to be changed. We describe the safety and the effectiveness of a technique designed to facilitate guide catheter advancement when faced with severe RAS.

We present our single-center experience using a novel mother-in-child assisted tracking (MiCAT) technique used to overcome severe RAS and facilitate guide catheter advancement to the aortic root. The MiCAT system consists of a 125 cm 4-Fr multipurpose (MP) diagnostic catheter inserted inside and protruding beyond a guiding catheter. The entire system can be advanced as one over a .035˝ guidewire into the aortic root. Procedural success was defined as achievement of the intended procedure without switching to an alternative access site with no vascular complications. The MiCAT system was utilized in 22 (0.59%) out of 3392 patients who underwent angiography between October 2019 and January 2021, with severe RAS hindering advancement of a 6 Fr guiding catheter despite conventional pharmacological therapy. MiCAT was successfully achieved via the left (55%) and right (45%) radial access routes using different 6-Fr guiding catheters. Procedural success was 100% and no vascular access or arterial complications were observed.

In our early experience, the MiCAT technique was a safe and effective strategy to facilitate guide catheter advancement.