Balloon‐assisted tracking: A must‐know technique to overcome difficult anatomy during transradial approach. Issue 2 (9th May 2013)

• Record Type: Journal Article
• Authors: Patel, Tejas; Shah, Sanjay; Pancholy, Samir; Rao, Sunil; Bertrand, Olivier F.; Kwan, Tak
• Is Part Of: Catheterization and cardiovascular interventions. Volume 83:Issue 2(2014:Feb. 01)
• Page Start: 211
• Page End: 220
• Publication Date: 2013-05-09
• Subjects: Heart -- Diseases -- Diagnosis -- Periodicals; Cardiac catheterization -- Periodicals; 616.1207572
• DOI: 10.1002/ccd.24959
• Languages: English
• ISSNs: 1522-1946

Abstract

<abstract abstract-type="main"> <title> <x xml:space="preserve">Abstract</x> </title> <sec id="ccd24959-sec-0001" sec-type="section"> <title>Objective</title> <p>To examine the use and outcomes of balloon‐assisted tracking (BAT) technique for dealing with complexities of arm and chest vasculature during transradial approach (TRA) at a single high volume radial center.</p> </sec> <sec id="ccd24959-sec-0002" sec-type="section"> <title>Background</title> <p>TRA has been used for coronary angiography and percutaneous coronary interventions (PCI) around the world. Different techniques have been described to address the anatomical issues and tortuosities for successful completion of coronary angiography and PCI. This study describes the use of BAT technique and associated outcomes during real world clinical practice.</p> </sec> <sec id="ccd24959-sec-0003" sec-type="section"> <title>Methods</title> <p>Subjects comprised 63 patients, (out of total 8, 245 patients between January 2011 and December 2012) in whom we encountered significantly complex anatomical course in radial, brachial, or subclavian region, leading to difficult advancement of a diagnostic or a guide catheter despite trying all standard maneuvers. In all of them BAT technique was used and they were retrospectively analyzed for the purpose of this study.</p> </sec> <sec id="ccd24959-sec-0004" sec-type="section"> <title>Results</title> <p>About 63 (0.76%) of 8, 245 patients met the study criteria. Twenty‐five (39.7%) patients had very small RA. Twenty‐two (34.9%) had severe RA tortuosity. Four (6.3%) had complex RA loops. Six (9.5%) had severe RA spasm and six (9.5%) had severe subclavian tortuosity and/or stenosis. We encountered technical failure in three (4.8%) patients (two had very small RA and one had 360 degree RA loop).</p> </sec> <sec id="ccd24959-sec-0005" sec-type="section"> <title>Conclusion</title> <p>BAT technique was useful to address the anatomical issues and tortuosities of radial, brachial, and subclavian vasculature during TRA. © 2013 Wiley Periodicals, Inc.</p> </sec> </abstract>