ABSTRACT
BACKGROUND: In percutaneous coronary interventions, use of the radial artery may be limited by vascular anatomy or vascular complications, such as radial artery spasm, dissection or perforation. The balloon-assisted tracking (BAT) technique is a novel and innovative method to successfully perform transradial procedures in patients with difficult vascular anatomy, severe tortuosity or radial artery spasm. In addition, the BAT technique can serve as a bail-out technique when vascular complications such as artery dissection or perforation occur. OBJECTIVE: We analysed data of all percutaneous coronary intervention patients in whom the BAT technique was undertaken in daily practice and report acute and long-term outcomes. RESULTS: A total of 62 patients were included and, in most patients, the BAT technique was performed for radial spasm. Most patients were administered benzodiazepines or nitrates before the BAT technique was performed. The primary end point, defined as successful passage of the catheter through the artery of the arm using the BAT technique, was 98%. 11% of patients developed a complication within 24 h (haematoma, prolonged pain or visible vascular damage at the end of procedure); all completely recovered at follow-up. No complications occurred during long-term follow-up. CONCLUSION: BAT is a low-risk and easy-to-use technique that increases the success rate of radial artery access and may prevent vascular complications.
Subject(s)
Arterial Occlusive Diseases/prevention & control , Catheterization, Peripheral/instrumentation , Percutaneous Coronary Intervention/instrumentation , Radial Artery/injuries , Vascular Access Devices , Vascular System Injuries/prevention & control , Aged , Arterial Occlusive Diseases/etiology , Arterial Occlusive Diseases/physiopathology , Cardiac Catheterization/adverse effects , Cardiac Catheterization/instrumentation , Cardiac Catheters , Catheterization, Peripheral/adverse effects , Equipment Design , Female , Humans , Male , Middle Aged , Percutaneous Coronary Intervention/adverse effects , Punctures , Radial Artery/diagnostic imaging , Radial Artery/physiopathology , Retrospective Studies , Risk Factors , Treatment Outcome , Vascular System Injuries/etiology , Vascular System Injuries/physiopathology , VasoconstrictionSubject(s)
Aortic Aneurysm, Abdominal/surgery , Blood Vessel Prosthesis Implantation/adverse effects , Renal Artery Obstruction/etiology , Angiography, Digital Subtraction , Aortic Aneurysm, Abdominal/diagnosis , Aortography/methods , Blood Vessel Prosthesis , Blood Vessel Prosthesis Implantation/instrumentation , Humans , Male , Middle Aged , Predictive Value of Tests , Renal Artery Obstruction/diagnosis , Renal Artery Obstruction/therapy , Stents , Tomography, X-Ray Computed , Treatment OutcomeSubject(s)
Endocarditis, Subacute Bacterial/complications , Myocardial Infarction/etiology , Panophthalmitis/microbiology , Aged , Brain Abscess/diagnosis , Brain Abscess/microbiology , Coronary Occlusion/microbiology , Echocardiography, Transesophageal , Endocarditis, Subacute Bacterial/diagnosis , Humans , Magnetic Resonance Imaging , Male , Myocardial Infarction/microbiology , Streptococcal Infections/diagnosisSubject(s)
Aneurysm, False/etiology , Aneurysm, Infected/etiology , Aortic Aneurysm/etiology , Aortic Rupture/etiology , Aortic Valve Stenosis/therapy , Cardiac Catheterization/adverse effects , Heart Valve Prosthesis Implantation/adverse effects , Aged , Aneurysm, False/diagnosis , Aneurysm, False/drug therapy , Aneurysm, False/microbiology , Aneurysm, Infected/diagnosis , Aneurysm, Infected/drug therapy , Aneurysm, Infected/microbiology , Anti-Bacterial Agents/therapeutic use , Aortic Aneurysm/diagnosis , Aortic Aneurysm/drug therapy , Aortic Aneurysm/microbiology , Aortic Rupture/diagnosis , Aortic Rupture/drug therapy , Aortic Rupture/microbiology , Aortography/methods , Echocardiography, Transesophageal , Fatal Outcome , Heart Valve Prosthesis Implantation/methods , Hematoma/etiology , Humans , Male , Multiple Organ Failure/etiology , Sepsis/etiology , Severity of Illness Index , Staphylococcus epidermidis/isolation & purification , Time Factors , Tomography, X-Ray ComputedSubject(s)
Arterio-Arterial Fistula/complications , Bronchial Arteries , Bronchiectasis/complications , Coronary Artery Disease/complications , Pulmonary Artery , Arterio-Arterial Fistula/diagnosis , Bronchial Arteries/diagnostic imaging , Bronchiectasis/diagnosis , Coronary Angiography , Coronary Artery Disease/diagnosis , Female , Humans , Magnetic Resonance Angiography , Middle Aged , Pulmonary Artery/diagnostic imaging , Tomography, X-Ray ComputedSubject(s)
Coronary Aneurysm/diagnosis , Coronary Artery Bypass/adverse effects , Aged, 80 and over , Coronary Aneurysm/etiology , Coronary Artery Bypass/methods , Echocardiography, Transesophageal , Humans , Magnetic Resonance Angiography , Male , Saphenous Vein/transplantation , Tomography, X-Ray ComputedSubject(s)
Aortic Aneurysm/diagnostic imaging , Aortic Dissection/diagnostic imaging , Aortography/methods , Marfan Syndrome/complications , Tomography, X-Ray Computed , Adult , Aortic Dissection/etiology , Aortic Dissection/surgery , Aortic Aneurysm/etiology , Aortic Aneurysm/surgery , Humans , Male , Marfan Syndrome/diagnostic imaging , Marfan Syndrome/surgery , Neck Pain/etiology , Vascular Surgical ProceduresABSTRACT
We describe a case of impressive/large bilateral coronary artery fistulae in a patient who developed transient symptoms of palpitations during pregnancy. As this woman remained asymptomatic and her haemodynamic reserves during multiple pregnancies had been good, it was decided to apply a conservative approach. Consideration, in certain circumstances, should be given as to closure of these fistulae, in view of the potential to develop pulmonary hypertension as a result of a significant cardiovascular shunt.
Subject(s)
Coronary Vessel Anomalies/diagnostic imaging , Vascular Fistula/diagnostic imaging , Adult , Coronary Artery Disease/diagnosis , Coronary Artery Disease/diagnostic imaging , Coronary Vessel Anomalies/diagnosis , Female , Humans , Pregnancy , Pregnancy Complications/diagnosis , Pregnancy Complications/diagnostic imaging , Radiography , Vascular Fistula/diagnosisABSTRACT
We report the case of a 73-year-old previously fit man who presented with a 10-month history of worsening dyspnoea on exertion. Transthoracic echocardiography showed a mass in the right ventricle. The diagnosis of non-coronary sinus of Valsalva aneurysm was confirmed by cardiac magnetic resonance imaging. The patient underwent surgical removal of the aneurysm with uneventful recovery. Since this rare anomaly may arise from different aetiological backgrounds, it is important to consider this condition in the differential diagnosis and diagnostic process in order to deliver prompt, and potentially life-saving, treatment.
Subject(s)
Aortic Aneurysm/diagnosis , Sinus of Valsalva/diagnostic imaging , Aged , Aortic Aneurysm/complications , Aortic Aneurysm/surgery , Dyspnea/etiology , Echocardiography , Humans , Magnetic Resonance Imaging , MaleABSTRACT
Athletes performing repetitive movements can develop arterial injuries. These are uncommon. We present a case of bilateral subclavian/axillary artery stenosis in a female patient referred to the rapid access chest pain clinic with a presumptive diagnosis of angina. Her symptoms were related to limb ischemia rather than cardiac insufficiency. Detailed history from this patient revealed that she had spent 8 years working as an acrobat being swung by the arms twice daily during performances.
