Transradial is one of the big buzzwords in interventional cardiology these days. In the United States practitioners recently have been discovering its advantages and have been learning how to perform it successfully. Utilization of transradial in the U.S. has jumped from 2% to almost 25% in less than a decade. In Europe, Japan, India, and China, transradial has been used for years and in most of those regions adoption runs from 50-90% of all catheter-based procedures. In Japan, and now in Europe, a specialized group of physicians has been pushing the limit of what can be done via the wrist artery, using “slender” procedures and equipment, with systems using 3, 4 and 5F sized catheters.
But the heart (pun intended) of this revolution in catheter-based access goes back over two decades to the pioneering work done by Dr. Ferdinand Kiemeneij, rightly dubbed “the father of transradial intervention.” You can read my interview with Dr. Kiemeneij here, but more importantly, you can and should and must read his brand-new hot-off-the-press book, “Transradial Coronary Interzentions,” available on Amazon. Continue reading
Slender Club Europe 2014: a new initiative of Slender Club Japan
A criticism from some cardiologists of the transradial approach, in which diagnostic angiography and percutaneous interventions (angioplasty and stents) are performed through the radial artery in the wrist, has been that the radial artery is too small to permit successful navigation of the various sheaths, wires and catheters. Of course, it’s been more than two decades since Dr. Ferdinand Kiemeneij successfully opened a blocked coronary artery via the wrist and today, in many parts of the world, half of all procedures are done this way. Continue reading
On the occasion of the 20th anniversary of transradial intervention (TRI), I talked with Dr. Ferdinand Kiemeneij, “the father of transradial intervention” who practices interventional cardiology at Onze Lieve Vrouwe Gasthuis (OLVG), Amsterdam, The Netherlands.
We covered a wide range of topics regarding TRI, where angioplasty and stents are placed via the wrist, and we’ve just posted the two-part interview on Angioplasty.Org. Continue reading
Patient exchange in cath lab at Kihara Cardiovascular Hospital in Japan
Earlier today I reported on an important study, published online first in Circulation: Cardiovascular Quality and Outcomes. The study fed the results from 14 radial vs. femoral trials (RIVAL et al) into the cost-benefit analysis machine at Penn Medicine’s Center for Evidence-based Practice (CEP).
And the results? The transradial wrist approach to catheter-based procedures (angiograms, stents, etc.) was less expensive ($275 per procedure) and resulted in two-thirds less complications than the femoral/groin approach. Continue reading
IVUS image shows stent under-expansion (click for larger image)
A recent paper, published online before print in SCAI’s journal, Catheterization and Cardiovascular Interventions, yet again adds to the evidence that intravascular ultrasound (IVUS) imaging during PCI can improve stent placement and expansion in a way that may prevent stent thrombosis (ST).
Titled, “Angiographically confirmed stent thrombosis in contemporary practice: insights from intravascular ultrasound“, the study looked at five years (2005-2010) of a multicenter registry of stent thromboses and studied the IVUS images where performed. Continue reading