The radial artery approach: We have come such a long way for the long way
✍ Scribed by Julius H. Grollman Jr.
- Publisher
- John Wiley and Sons
- Year
- 2000
- Tongue
- English
- Weight
- 20 KB
- Volume
- 49
- Category
- Article
- ISSN
- 1522-1946
No coin nor oath required. For personal study only.
✦ Synopsis
The transradial approach to the aorta and its branches goes back a long way, having been originally described by Radner in 1948 [1]. However, in spite of Radner's initial success, the procedure performed by open arteriotomy was difficult and encountered significant complications, never becoming a mainstream technique. The following year Jo ¨nsson [2] reported an alternative approach to the thoracic aorta percutaneously passing a metallic canula retrogradely into the right common carotid artery. The canula was then advanced over a silver thread, the predecessor of the standard guidewire described by Seldinger [3], into the thoracic aortic arch. Jo ¨nsson [4] had also previously tried the transradial approach for nonselective coronary visualization but abandoned this access route stating: "Experience has proven, however, that this method has a number of drawbacks. It is complicated and takes a great deal of time. In many cases the radial artery has to be sacrificed. Even if it is sutured, it often becomes obliterated. There is an extensive collateral system, of course, but it goes against the grain to destroy an artery unless it is absolutely unavoidable. Another disadvantage of the method is that it is sometimes impossible to introduce the catheter in the aorta because of angiospasm. Spasmolytics and other drugs with a dilating effect seldom, if ever, succeed in doing away with this form of spasm" [2].
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