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.

Transradial cardiac catheterisation has been reported to be more beneficial compared to other approaches due to many reasons:
1- it is easier and safer post-procedural haemostasis
2- better patient comfort
3- earlier ambulation and possibility of performing procedure and discharge on the same day.
There is only limited data examining transradial access in the elderly population.
Elderly population may be at higher risk of vascular access site bleeding and the transradial approach has shown equal efficacy to the transfemoral approach.
In addition to that, the transradial approach significantly reduces vascular complications, hospital stay, mobilization times and adverse cardiac events.
In results, the transradial approach should be considered as the preferred vascular access site in the elderly population.

Nevertheless, along with its advantages, the transradial approach has some problems during the learning curve in the elderly with higher rates of crossover site usage, increased fluoroscopy and therefore radiation time and longer procedure time.

The Transradial Cardiac Catheterization Technique is very simple for any expert, you only should follow the steps carefully.
Under sterile conditions, the radial artery is accessed with a 20- to 21-gauge needle, and a 5F-6F sheath is advanced into the artery over a wire using the Seldinger technique.
Vasodilators (usually verapamil and nitroglycerin) are administered to reduce radial artery spasm.
Hydrophilic sheaths are generally used to minimize trauma to the radial artery.
An anticoagulant (usually unfractionated heparin [UFH] or bivalirudin) is given to prevent radial artery thrombosis
And there is a review in 2017 that found that observational studies suggest a benefit of higher-dose vs lower-dose UFH in reducing post-transradial cardiac catheterization radial artery occlusion, but the findings were less clear in randomized trials.
In a 2019 single-center study that evaluated radial artery occlusion in 686 patients who underwent diagnostic cardiac catheterization and received either 100 IU/kg UFH (high dose) or 50 IU/kg UFH (standard dose), investigators found an independent association between lower rates of radial artery occlusion and high-dose UFH.

Catheters are advanced over the guidewire and used for coronary angiography and/or coronary intervention.
Specialized catheters shaped to aid in engaging the coronary arteries from the transradial approach have been developed, although traditional coronary catheters can also be used.

After the procedure, the sheath is removed and pressure is held over the arteriotomy site to achieve hemostasis.
Several devices have been developed to assist in maintaining pressure on the wrist; most are bands that allow easy modification of hemostatic pressure.

Further details you will find during this lecture, and finally as doctors and experts, we should always remember that Attaining proficiency in transradial catheterization and intervention, especially for a seasoned practitioner experienced in transfemoral procedures, requires time, effort, and humility.

Don’t forget to learn more about the other courses by visiting the courses library on Sameh Allam website: https://samehallam.com/


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