You could learn more about cardiology courses with Prof. Sameh Allam by clicking on the courses’ library link here:

Objectives for this course:
1- Master the essentials of a successful complex PCI by using the radial approach
2- Essential questions on radial approach and the use of the specific radial device(s)
3- Clinical case strategy and radial approach limits
4- Anatomical variations in the Radial artery.
5- Master the essential steps of a successful radial procedure.

Cardiac catheterization has continually evolved since the first procedure in 1929. Improvement in technology and understanding the anatomic features of the vascular system, have led to new insights in coronary angiography procedures. With regard to arterial access sites, much research has been devoted to determine which access site is best suited for particular patients and circumstances. In spite of the ease of access of femoral artery for coronary angiography, vessel-related complications and bleeding have given rise to increased morbidity, mortality, and hospital stay, particularly when anticoagulation and antiplatelet therapy are administered.

The femoral approach has been compared with radial approach for both coronary angiography and interventional procedures in multiple randomized and observational studies. Increased safety and patient comfort with reduction of bleeding complications and immediate postprocedural mobilization were found as the major advantages of radial access.

Angioplasty uses a balloon-tipped catheter to open a blocked blood vessel and improve blood flow. The doctor uses medical imaging to guide the catheter to the blockage. The balloon is inflated to open the vessel and improve blood flow. It may be done with or without a metal mesh tube called a stent. The stent is left inside the blood vessel to help keep it open. Angioplasty is minimally invasive and usually does not require general anesthesia.

Angioplasty with or without stenting is commonly used to treat conditions that narrow or block blood vessels and interrupt blood flow. These conditions include:
1- coronary artery disease, a narrowing of the arteries that carry blood and oxygen to the heart muscle.
2- narrowing of the large arteries due to hardening of the arteries or atherosclerosis. This is a build-up of cholesterol and other fatty deposits, called plaques, on the artery walls.
3- peripheral artery disease (PAD), a narrowing of the arteries in the legs or arms.
4- carotid artery stenosis, a narrowing of the neck arteries supplying blood to the brain.
5- narrowing or blockage in the veins in the chest, abdomen, pelvis, arms and legs.
6- renovascular hypertension, high blood pressure caused by a narrowing of the kidney arteries.
7- Angioplasty and stenting may be used to help improve kidney function.
narrowing in dialysis fistula or grafts.
8- Fistulas and grafts are artificial blood vessel connections doctors use in kidney dialysis.
9- Angioplasty is generally used when these connections become narrow or blocked.
10- Stenting may also be needed in some cases.

There are two main ways to access the coronary arteries and perform the procedure:
– the femoral artery in the groin
– the radial artery in the wrist.
First: Radial
The large artery in the patient’s wrist is used to access his heart arteries. After the procedure, a band will be placed around the patient’s wrist to stop the little cut in his wrist from bleeding. The patient will need to keep his wrist and arm still.
Over time, the air inside the band will be deflated and the band removed. The patient will be able to sit up, eat and drink and rest in bed while the band is being deflated.

Femoral
The large artery in the body groin is used if the patient has had prior coronary artery bypass graft surgery (CABGS) or if the wrist artery is not suitable.
Once the procedure is finished, the sheath (thin plastic tubing) will remain in the patient's groin and removed, when the doctor or nurses deem it safe to do so.
This is usually once the blood thinning medications used during the procedure have worn off.
When the sheath is removed, you as a doctor will apply firm pressure to the area for around 20 minutes.
It is important that the patient lies flat and very still. The patient will then have to lie flat for a further 2 to 4 hours. However, the patient can eat and drink once the doctor has finished
applying pressure to the area.

#Radial_course #cardiac_catheterization #cardiology #cardiology_course #catheterization #Radial_approach #coronary_angiography #angiography #coronary_disease #atheterization_approach #سامح_علام
#دكتور_قلب #كورس_كارديولوجي