Balloon-assisted tracking: a must-know technique to overcome difficult anatomy during transradial approach.

Published

Journal Article

OBJECTIVE: 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. BACKGROUND: 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. METHODS: 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. RESULTS: 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). CONCLUSION: BAT technique was useful to address the anatomical issues and tortuosities of radial, brachial, and subclavian vasculature during TRA.

Full Text

Duke Authors

Cited Authors

  • Patel, T; Shah, S; Pancholy, S; Rao, S; Bertrand, OF; Kwan, T

Published Date

  • February 2014

Published In

Volume / Issue

  • 83 / 2

Start / End Page

  • 211 - 220

PubMed ID

  • 23592578

Pubmed Central ID

  • 23592578

Electronic International Standard Serial Number (EISSN)

  • 1522-726X

Digital Object Identifier (DOI)

  • 10.1002/ccd.24959

Language

  • eng

Conference Location

  • United States