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Int J Angiol 2016; 25(02): 134-136
DOI: 10.1055/s-0035-1552981
Case Report
Thieme Medical Publishers 333 Seventh Avenue, New York, NY 10001, USA.

Balloon-Assisted Tracking: A Solution to Severe Subclavian Tortuosity Encountered During Transradial Primary PCI

Surya Dharma
1   Department of Cardiology and Vascular Medicine, University of Indonesia, National Cardiovascular Center, Harapan Kita, Jakarta, Indonesia
,
Ian C. Gilchrist
2   Department of Cardiology, Pennsylvania State University College of Medicine, Penn State Heart and Vascular Institute, Hershey, Pennsylvania
,
Tejas Patel
3   Department of Cardiovascular Sciences, Apex Heart Institute, Ahmedabad, Gujarat, India
› Author Affiliations
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Publication History

Publication Date:
25 May 2015 (online)

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Abstract

Radial artery access is preferred over femoral access for primary percutaneous coronary intervention (PCI) in patients with acute ST-segment elevation myocardial infarction because of the reduction in access site complications and mortality associated with the radial artery access. Successful transradial primary PCI requires knowledge of techniques to handle unexpected severe subclavian artery tortuosity. Balloon-assisted tracking (BAT) is one technique developed to negotiate the tortuosity and loops in the upper extremity. However, the use of BAT in dealing with a severe subclavian loop during a transradial primary PCI procedure has never been reported. We described a case of transradial primary PCI with severe subclavian artery loop that was negotiated successfully by the BAT technique.

Keywords

radial artery access - balloon-assisted tracking - subclavian artery loop - primary PCI

Note

There is no external funding and this report has no relationship with any industrial company.


 

  • References

  • 1 Bertrand OF, Bélisle P, Joyal D , et al. Comparison of transradial and femoral approaches for percutaneous coronary interventions: a systematic review and hierarchical Bayesian meta-analysis. Am Heart J 2012; 163 (4) 632-648
    CrossrefPubMedGoogle Scholar
  • 2 Kedev S, Kalpak O, Dharma S , et al. Complete transitioning to the radial approach for primary percutaneous coronary intervention: a real-world single-center registry of 1808 consecutive patients with acute ST-elevation myocardial infarction. J Invasive Cardiol 2014; 26 (9) 475-482
    PubMedGoogle Scholar
  • 3 Norgaz T, Gorgulu S, Dagdelen S. Arterial anatomic variations and its influence on transradial coronary procedural outcome. J Interv Cardiol 2012; 25 (4) 418-424
    CrossrefPubMedGoogle Scholar
  • 4 Patel T, Shah S, Pancholy S, Rao S, Bertrand OF, Kwan T. Balloon-assisted tracking: a must-know technique to overcome difficult anatomy during transradial approach. Catheter Cardiovasc Interv 2014; 83 (2) 211-220
    CrossrefPubMedGoogle Scholar
  • 5 Deora S, Shah S, Patel T. Balloon-assisted tracking in dealing with radial artery loop by transradial approach: a technical report. J Invasive Cardiol 2014; 26 (5) E61-E62
    PubMedGoogle Scholar
  • 6 Deora S, Shah S, Patel T. Balloon-assisted tracking of guide catheter dealing with radial artery perforation and subclavian loop during percutaneous coronary intervention by transradial approach. Int J Cardiol 2013; 167 (6) e161-e162
    CrossrefPubMedGoogle Scholar
  • 7 Oderich GS, Mendes BC, Kanamori KS. Technique of implantation and bail-out maneuvers for endovascular fenestrated repair of juxtarenal aortic aneurysms. Perspect Vasc Surg Endovasc Ther 2013; 25 (1-2) 28-37
    CrossrefPubMedGoogle Scholar
  • 8 Cola C, Miranda F, Vaquerizo B, Fantuzzi A, Bruguera J. The Guideliner™ catheter for stent delivery in difficult cases: tips and tricks. J Interv Cardiol 2011; 24 (5) 450-461
    CrossrefPubMedGoogle Scholar