Use this URL to cite or link to this record in EThOS: http://ethos.bl.uk/OrderDetails.do?uin=uk.bl.ethos.721620
Title: Assessment of the radial artery access site and its use in invasive cardiac procedures
Author: Lo, Ted Su Neng
Awarding Body: Keele University
Current Institution: Keele University
Date of Award: 2013
Availability of Full Text:
Access from EThOS:
Access from Institution:
Abstract:
Vascular access via the radial artery has recently been shown to reduce access site related vascular complications but is associated with a significant learning curve. Radial artery spasm, arterial puncture failure, vascular anomalies, failure to reach the ascending aorta and concern regarding higher radiation exposure with the transradial are some obstacles that impede widespread uptake of this technique. This study was performed to assess some of these learning curve issues and to explore the use of transradial access in high-risk patient subgroups. Six interlinked projects were setup for this study and a total of 3125 patients evaluated. Access site vascular complications remain unacceptably high in contemporary practice as discussed in Chapter 2. The transradial approach could minimise such complications. Radial artery anomalies are relatively common and are a common cause of transradial procedure failure as detailed in Chapter 3. Forearm arterial diameter variations and the effect of sublingual GTN were discussed in Chapter 4. The radial artery is bigger than the ulnar artery and GTN increases their diameters by an average of 15-22%. The issues with radiation exposure were studied as detailed in Chapter 5. With strict control of various variables and optimal radiation protection, we demonstrated that there is no difference in radiation exposure between transradial and transfemoral diagnostic angiography when performed by an experienced operator. The application of transradial technique in 2 high-risk patient subgroups was analysed as detailed in Chapter 6. Transradial rescue angioplasty for failed reperfusion and percutaneous right and left heart catheterisation via the arm approach without interruption to Warfarin therapy are found to be safe and effective. These findings have important clinical implication and may help shorten the learning curve and optimise procedure technique including high-risk patient subgroups, thereby help to further drive the adoption of transradial approach.
Supervisor: Not available Sponsor: Not available
Qualification Name: Thesis (M.D.) Qualification Level: Doctoral
EThOS ID: uk.bl.ethos.721620  DOI: Not available
Keywords: R Medicine (General)
Share: