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Transradial interventions -local perspective Dr Syed Nadeem Hassan Rizvi, MBBS (Pb), Dip Card (lon), MRCP(UK), FSCAI As. Professor of Cardiology, National.

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Presentation on theme: "Transradial interventions -local perspective Dr Syed Nadeem Hassan Rizvi, MBBS (Pb), Dip Card (lon), MRCP(UK), FSCAI As. Professor of Cardiology, National."— Presentation transcript:

1 Transradial interventions -local perspective Dr Syed Nadeem Hassan Rizvi, MBBS (Pb), Dip Card (lon), MRCP(UK), FSCAI As. Professor of Cardiology, National institute of Cardiovascular diseases, Karachi

2 Why Transradial ? Early (immediate?) ambulation Early (immediate?) ambulation Less local complications than transfemoral Less local complications than transfemoral Less labour / staff intensive Less labour / staff intensive

3 Downside of transradial Steep learning curve Steep learning curve Limited availability of specific radial catheters at present Limited availability of specific radial catheters at present Access limited upto 7F in most patients, which therefore, excludes certain techniques e.g simultaneous stenting and IABP insertion Access limited upto 7F in most patients, which therefore, excludes certain techniques e.g simultaneous stenting and IABP insertion

4 TRI-Preparation

5 TRI-Preparation

6 TRI-Preparation

7 TRI-Preparation

8 TRI-Final table setup

9 TRI- Local anaesthetic

10 TRI- Access

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14 TRI- Sheath removal

15 TRI- Access closure / TR band

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17 TRI – TR band closure

18 TRI- Immediate ambulation

19 TRI- Material Radistop Radstat Stepty P Easy Radial Gauze and tape/ bandage

20 TRI- Diagnostic catheters

21 TRI- Guiding catheters

22 Guide catheters Radial curve (BSS) Muta wiseguide (BSS) Fadajet (Cordis) Kimney Runway (BSS) Mann IMA (BSS)

23 Radial / brachial anatomy

24 JR for LCA

25 TRI- Primary PCI

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28 TRI – Kissing balloon (6F access)

29 TRI- bifurcation PCI

30 TRI – bifurcation PCI

31 TRI – Complex rescue PCI

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34 Conclusion I TRI is a safe and effective procedure TRI is a safe and effective procedure Has a steep learning curve and therefore needs persistence and dedication to master technique Has a steep learning curve and therefore needs persistence and dedication to master technique Variety of specific hardware is limited in Pakistan mainly due to low volumes Variety of specific hardware is limited in Pakistan mainly due to low volumes

35 Conclusion II Fluro times are marginally longer than femoral procedures but usually decline with increasing expertise Fluro times are marginally longer than femoral procedures but usually decline with increasing expertise No specific subgroup should be exempted from this technique except those where >7F diameter access is necessary No specific subgroup should be exempted from this technique except those where >7F diameter access is necessary Teaching institutes should try and adopt this technique as first line due to its safety and cost effectiveness Teaching institutes should try and adopt this technique as first line due to its safety and cost effectiveness

36 Thank You


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