Related Experiment Videos
Percutaneous left heart catheterization and coronary arteriography with and without an arterial sheath in patients
Insights
Using an arterial sheath for percutaneous catheter introduction during cardiac procedures offers advantages, particularly for patients with low pain tolerance. This method proved comparable to the Seldinger technique in safety and complication rates.
Area of Science:
- Cardiology
- Vascular Surgery
- Interventional Radiology
Background:
- Percutaneous catheter introduction via the femoral artery is a common procedure.
- Arterial sheaths are an alternative to the standard Seldinger technique for catheter insertion.
- Evaluating the safety and efficacy of arterial sheaths is important for patient care.
Purpose of the Study:
- To prospectively compare the advantages and disadvantages of using an arterial sheath versus the standard Seldinger technique for percutaneous catheter introduction.
- To assess complication rates, specifically groin hematomas and patient discomfort, associated with each method.
Main Methods:
- A prospective study involving 184 consecutive patients undergoing diagnostic left heart catheterization and coronary arteriography.
- Randomized allocation of patients into two groups: arterial sheath (91 patients) and standard Seldinger technique (93 patients).
- Standardized anesthesia (lidocaine) and anticoagulation (heparin) protocols were applied to all participants.
Main Results:
- No major complications were observed in either the arterial sheath or control groups.
- No significant difference in the incidence of groin hematomas between the two groups.
- Patients in the control group (Seldinger technique) experienced more frequent moderate to severe discomfort, often requiring additional local anesthesia.
Conclusions:
- The use of an arterial sheath for percutaneous catheter introduction in left heart catheterization and coronary arteriography is advisable.
- Arterial sheaths are particularly beneficial for anxious patients or those with a low pain threshold.
- The arterial sheath technique is a safe and effective alternative to the Seldinger technique, with comparable complication rates and improved patient comfort.
Abstract:
The advantages and disadvantages of an arterial sheath to introduce catheters percutaneously through the femoral artery were prospectively studied in 184 consecutive patients without peripheral vascular disease undergoing routine diagnostic left heart catheterization and coronary arteriography. The arterial sheath was used randomly in 91 patients (sheath group) and the standard Seldinger technique in 93 (control group). There were no differences in age or sex between the two groups. All patients were studied with no premedication and had the same dose of lidocaine local anesthesia and heparin. No major complication occurred in any of the patients in the sheath or control groups. There were no significant differences in groin hematomas between the two groups. The patients in the control group more commonly had severe or moderately severe discomfort requiring additional local anesthesia. We conclude that the use of an arterial sheath percutaneously for introduction of catheters for left heart catheterization and coronary arteriography is advisable, particularly for anxious patients who have a low pain threshold.