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Left heart catheterization and angiography via the percutaneous femoral approach using an arterial sheath
Insights
Arterial sheaths in cardiac catheterization significantly reduce complications and patient discomfort. This technique offers improved safety and ease during femoral procedures, becoming a standard practice.
Area of Science:
- Cardiovascular Medicine
- Interventional Cardiology
- Medical Devices
Background:
- The femoral approach is common for cardiac catheterization and angiography.
- Conventional percutaneous femoral access can be associated with complications.
- Improving patient safety and procedural efficiency is a key goal in interventional cardiology.
Purpose of the Study:
- To evaluate the safety and efficacy of using an arterial sheath with a hemostasis valve and side-arm extension tube.
- To compare complication rates with the conventional percutaneous femoral approach.
- To assess the benefits of the arterial sheath in facilitating procedures and monitoring.
Main Methods:
- A prospective study involving 562 consecutive patients undergoing cardiac catheterization and angiography.
- Utilized an arterial sheath with a proximal hemostasis valve and side-arm extension tube.
- Compared outcomes and complication rates with historical data and conventional methods.
Main Results:
- Serious complications were rare, including one death, one peripheral embolism, and one delayed groin hemorrhage.
- Minor complication rates, such as hematoma, were favorable compared to conventional techniques.
- The sheath facilitated catheter exchanges, reduced patient discomfort, and allowed for femoral artery pressure monitoring.
Conclusions:
- The arterial sheath technique is safe and effective for cardiac catheterization via the femoral approach.
- This method offers advantages in terms of reduced complications, improved procedural ease, and patient comfort.
- The use of arterial sheaths has become the standard practice for left heart catheterization via the femoral route.
Abstract:
An arterial sheath with a proximal hemostasis valve and a side-arm extension tube was used in 562 consecutive patients undergoing cardiac catheterization and angiography via the femoral approach. Serious complications were rare. There was one death, one peripheral embolism, and one episode of delayed groin hemorrhage. The incidence of minor complications, including hematoma formation, in this series compares favorably with our own and the reported experience of others using the conventional percutaneous femoral approach. The sheath technique facilitated catheter exchanges and reduced patient discomfort. In addition, femoral artery pressure could be monitored via the side arm of the sheath during the catheterization. This proved helpful during retrograde catheterization of patients with aortic stenosis, as well as in detection of damping of coronary artery catheter tip pressure during coronary arteriography and hypotension following left ventriculography. Based upon this experience, use of an arterial sheath has become our standard practice when left heart catheterization is performed via the femoral approach, and the use of several different catheters is anticipated.