A novel technique for accessing the pericardial space.

Area of Science:

• Cardiology
• Interventional Cardiology
• Medical Devices

Background:

• Pericardial procedures carry risks, especially with minimal pericardial effusion or adhesions.
• Existing pericardiocentesis techniques may pose challenges in specific patient subsets.

Purpose of the Study:

• To introduce and evaluate an innovative wire puncture technique for enhanced safety in pericardiocentesis.
• To assess the feasibility and efficacy of the novel technique in challenging clinical scenarios.

Main Methods:

• Utilized a percutaneous transluminal coronary angioplasty guidewire's hard end for parietal pericardium puncture.
• Employed a flat-tipped metal tube for guidewire support and a microcatheter for guidewire exchange.
• Validated the technique's safety and feasibility in 10 pigs before human clinical trials.

Main Results:

• Achieved a 98.15% success rate in 10 pigs and 54 patients undergoing challenging pericardiocentesis.
• Demonstrated effectiveness in cases with minimal anterior effusion (5.50 ± 2.28 mm) and dry pericardiocentesis.
• Showed no significant complications and efficacy in acute iatrogenic pericardial effusion and pericardial adhesions.

Conclusions:

• The novel wire puncture technique is a safe and feasible approach for challenging pericardiocentesis.
• The technique offers a viable solution for procedures complicated by minimal effusion or pericardial adhesions.