RESUMEN
Angioplasty is most commonly performed with catheters introduced percutaneously into the femoral artery. A brachial approach has previously been described that employs arteriotomy and cutdown. We describe here the technique and initial results of an alternative method of brachial entry, wherein the catheter is introduced percutaneously. Angioplasty has been performed in 26 patients in this manner, without complications.
Asunto(s)
Angioplastia de Balón/métodos , Arteria Braquial , Adulto , Anciano , Humanos , Masculino , Persona de Mediana EdadRESUMEN
Left heart catheterization via percutaneous entry of the brachial artery was attempted in 1,783 cases. A plain sheath without valve or side-port was employed and 7 and 8 French Sones catheters were used for females and males, respectively. Successful performance of the procedure was achieved in 96.5% of the cases. Brachial artery occlusion occurred in 1.3% of the cases and was readily correctable. There were no major complications attributable to the method of brachial artery entry. This technique has advantages over the standard Sones technique employing cutdown and arteriotomy, and may be the preferred method of left heart catheterization by way of the upper extremity.
Asunto(s)
Arteria Braquial , Cateterismo Cardíaco/métodos , Adolescente , Adulto , Anciano , Cateterismo Cardíaco/efectos adversos , Cateterismo Cardíaco/instrumentación , Femenino , Humanos , Masculino , Persona de Mediana EdadRESUMEN
Percutaneous entry of the brachial artery using a sheath system has been attempted in 223 patients undergoing left heart catheterization; successfully, in 212. After arterial puncture, a dilator and sheath are passed over a short guidewire. A number 7-80 cm Sones specially stiffened coronary catheter is passed through the sheath, and left heart catheterization is performed in the usual manner. The study can usually be completed with this single catheter. Initial entry, as well as any needed catheter change, is facilitated by the use of an inflatable sphygmomanometer cuff around the upper arm. Ease of manipulation and patient comfort have been satisfactory, and brachial artery spasm has not been encountered. There have been no major complications and a low incidence (approximately 15%) of brachial arterial occlusion.