Vascular Assisted Tracking for Challenging Transradial Percutaneous Intervention

Merella, Pierluigi; Lorenzoni, Giovanni; Saderi, Laura; Sotgiu, Giovanni; Casu, Gavino

doi:10.1016/j.carrev.2020.08.007

Cited by 4 publications

(3 citation statements)

References 12 publications

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“…These challenges encompass resistant spasm, severe tortuosity, difficult loops, narrower vessels, stenotic lesions, and iatrogenic perforations [9][10][11][12]. The prevalence of these unfavorable anatomical variations varies from 2% to 10% in different studies and significantly contributes to procedure failure rates [10][11][12][13][14][15]. Larger studies investigating BAT have reported success rates ranging from 91% to 95%, with no associated complications [11][12][13].…”

Section: Resultsmentioning

confidence: 99%

“…In some cases, gentle rotational movements may be necessary to navigate through complex loops or severe tortuosity. The utilization of a ballooncatheter assembly with a soft, conical-shaped tip and a more coaxial alignment enables the negotiation of resistant areas without causing trauma, thereby minimizing the potential risk of tissue damage due to the catheter's sharp edges when encountering resistance against the arterial wall [10,12,15]. Furthermore, the balloonassisted tracking (BAT) technique can be adjusted by employing varying levels of balloon inflation pressure, depending on the specific anatomy of the radial artery.…”

Section: Parameters N =23mentioning

confidence: 99%

“…These structural challenges may include severe spasm, decreased artery width, atherosclerotic disease, complicated routes, complex loops, and the occasional dissection or perforation induced by catheter placement [9][10][11][12]. Several strategies have been used to circumvent these restrictions [12][13][14][15]. One such strategy, balloon-assisted tracking (BAT), first described by Patel et al has been shown to dramatically improve TRA success rates in difficult instances [12].…”

Section: Introductionmentioning

confidence: 99%

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Balloon asisted tracking technique in complex transradial access: A single center experience

Donmez,

Acar

2023

j-ebr

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The transradial technique (TRA) has become widely accepted for coronary catheterization. While TRA offers numerous benefits, certain anatomical challenges can lead to access failure. Balloon-assisted tracking (BAT) has emerged as a valuable technique to overcome these challenges and improve success rates. This study aims to evaluate the feasibility and efficacy of BAT during coronary interventions using TRA. Methods: A retrospective analysis was conducted on patients who underwent diagnostic or percutaneous coronary intervention (PCI) procedures between September 2020 and May 2023. Patient demographics, clinical data, and procedural information were collected for cases where BAT was employed to overcome radial or brachial arterial complexity. Results: A total of 23 patients encountered anatomical difficulties necessitating BAT during the procedure, both elective and acute coronary syndrome (ACS). Radial artery spasm was the most common indication for BAT, with a high proportion of female patients. Successful completion of coronary intervention using BAT, without the need for femoral artery crossover, was achieved in all cases except one. Also, the complexity of anatomy (such as tortuosity, arterial loop, or small artery crossing) was another reason for BAT use. The mean procedural time was 47.9 minutes, and no complications related to the access site were observed. Conclusions:The findings demonstrate that BAT is a safe and effective technique for overcoming complex radial artery anatomical challenges and radial spasm during TRA. The study supports the adoption of BAT in TRA procedures and highlights its potential benefits in both elective and ACS cases.

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