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Vascular access: Femoral, radial and large-bore alternative access
Kaushik Darbha1, Vincent J Long1, Caleb M Lowe1
1Charles R Drew University School of Medicine, Los Angeles, CA, United States of America.
Progress in Cardiovascular Diseases
|January 6, 2025
Summary
Vascular access techniques have advanced significantly for cardiac interventions. This review covers femoral, forearm, and alternative arterial access methods, emphasizing safety and evolving demands.
Area of Science:
- Cardiovascular Medicine
- Interventional Cardiology
- Vascular Surgery
Background:
- Vascular access has undergone significant evolution over the past 20 years.
- Increasing demand for large-bore access (e.g., for valvular interventions) and safer coronary access in complex patients drives innovation.
Purpose of the Study:
- To provide a comprehensive overview of arterial access techniques for cardiovascular interventions.
- To discuss evidence and experience for various access sites, including femoral, forearm, and alternative locations.
Main Methods:
- Review of current literature and clinical experience.
- Analysis of arterial access techniques in the femoral, radial, ulnar, transcarotid, transaxillary, and transcaval locations.
Main Results:
- Significant advancements in vascular access techniques have been observed.
- Techniques are tailored to specific intervention types (coronary, peripheral, structural) and patient comorbidities.
Conclusions:
- Arterial access strategies continue to evolve, offering improved safety and efficacy.
- Understanding diverse access techniques is crucial for optimal patient outcomes in interventional cardiology.
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