Application of ultrasound in cardiovascular intervention via the distal radial artery approach: New wine in old bottles?

Chen, Tao; Yu, Xiaohong; Song, Ruixiao; Li, Lamei; Cai, Gaojun

doi:10.3389/fcvm.2022.1019053

Cited by 3 publications

(3 citation statements)

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“…Despite the short accessible length, shallow depth, and limited diameter of the RA in the snuff box with complex surrounding structures, distal radial access through the snuff box has recently been performed [ 3 , 4 , 6 , 7 , 10 , 11 ]. In the following section, we will discuss how ultrasonography can be practically embedded in the cannulation process.…”

Section: Anatomical Considerationsmentioning

confidence: 99%

“…Compressibility tests can differentiate between the two types, and meticulous scanning can identify the superficial branch of the radial nerve. Ultrasound has an advantage over the tactile location in that the operator can also measure the arterial diameter and determine whether the radial artery can accommodate the required procedural sheath and equipment and choose a smaller diameter sheath in order to reduce the risk of vascular injury, unnecessary pain, and RAO [ 6 ]. Therefore, the use of ultrasound during distal access is highly recommended.…”

Section: Introductionmentioning

confidence: 99%

See 1 more Smart Citation

The Role of Ultrasound in Accessing the Distal Radial Artery at the Anatomical Snuffbox for Cardiovascular Interventions

Achim

Péter

Kákonyi

et al. 2022

Life

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In an effort to refine transcatheter vascular interventions, radial artery access has moved more distally at the anatomical snuffbox. Here, more challenges appear as the artery is smaller, more angulated, and more difficult to palpate. Including ultrasound guidance as a mandatory step during puncture may encourage more operators to switch to this approach. In the femoral approach, ultrasound guidance is strongly recommended because of bleeding complications, whereas in the proximal (conventional) radial approach, the role of ultrasound remains optional, and in current practice, almost all cases are performed by palpation of the pulse only. However, in distal radial access, the situation is different because the artery differs in caliber and position, and imaging can help the operator for a clean puncture, especially since repeated punctures are not only painful but also any hematoma formation leads to the complete compression of the artery and failure of access. The aim of this review is to investigate the rationale of vascular ultrasound during distal radial access and to establish some techniques and anatomical landmarks for the ultrasonographic exploration of the dorsal area of the hand.

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Section: Anatomical Considerationsmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

The Role of Ultrasound in Accessing the Distal Radial Artery at the Anatomical Snuffbox for Cardiovascular Interventions

Achim

Péter

Kákonyi

et al. 2022

Life

View full text Add to dashboard Cite

show abstract

“…It is that acute thrombotic RAO can undergo spontaneous recanalization, occurring at a rate of around 50–60% within 30 days (50% in TRA vs 68% in DRA) [ 1 ]. Notably, the design of CONDITION did not include intraprocedural US, i.e., US-guided (not palpation-guided) puncture, but other studies did, demonstrating proven benefits [ 8 ]. The versatility of DRA expands to larger sheaths as well (7–8 French) where inevitably the chance of RAO increases significantly and where US plays the role of screening a sufficiently sized artery diameter, while DRA’s anatomical characteristics may further mitigate RAO risk [ 9 ].…”

Section: Introductionmentioning

confidence: 99%