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Transradial interventions -local perspective

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Presentation on theme: "Transradial interventions -local perspective"— 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 Early (immediate?) ambulation
Why Transradial ? Early (immediate?) ambulation Less local complications than transfemoral Less ‘labour / staff ’ intensive

3 Downside of transradial
Steep learning curve 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

4 TRI-Preparation

5 TRI-Preparation

6 TRI-Preparation

7 TRI-Preparation

8 TRI-Final table setup

9 TRI- Local anaesthetic

10 TRI- Access

11 TRI- Access

12 TRI- Access

13 TRI - Access

14 TRI- Sheath removal

15 TRI- Access closure / TR band

16 TRI- Access closure / TR band

17 TRI – TR band closure

18 TRI- Immediate ambulation

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

20 TRI- Diagnostic catheters

21 TRI- Guiding catheters

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

23 Radial / brachial anatomy

24 JR for LCA

25 TRI- Primary PCI

26 TRI- Primary PCI

27 TRI- Primary PCI

28 TRI – Kissing balloon (6F access)

29 TRI- bifurcation PCI

30 TRI – bifurcation PCI

31 TRI – Complex rescue PCI

32 TRI – Complex rescue PCI


34 Conclusion I TRI is a safe and effective procedure
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

35 Conclusion II 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 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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