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Transradial catheterization
Transradial catheterization is an endovascular procedure or catherization procedure performed to diagnose and treat arterial disease (e.g., coronary artery disease, peripheral artery disease, etc.). Endovascular procedure can be performed achieving access in to body’s arterial system from either femoral artery (in groin), brachial artery (in elbow) or radial artery in the wrist. The transfemoral (through groin) approach to perform cardiac catheterization has typically been more prevalent in invasive cardiology. But, radial access has gained in popularity due to technical advances with catheters and lower complication rates than transfemoral access.〔Major improvement of percutaneous cardiovascular procedure outcomes with radial artery catheterisation: results from the PREVAIL study. Pristipino C, Trani C, Nazzaro MS, Berni A, Patti G, Patrizi R, Pironi B, Mazzarotto P, Gioffrè G, Biondi-Zoccai GG, Richichi G, Prospective REgistry of Vascular Access in Interventions in Lazio Region Study Group Heart. 2009 Mar; 95(6):476-82.〕
==History==
In 1948, Radner〔Radner S. Thoracal aortography by catheterization from the radial artery; preliminary report of a new technique Acta Radiol 1948;29:178-180.〕 published one of the first descriptions of transradial central arterial catheterization and attempts at coronary artery imaging using radial artery cut-down. Transradial access to perform diagnostic cardiac catheterization procedures, was introduced by Campeau〔Campeau L. Percutaneous radial artery approach for coronary angiography. Cathet Cardiovasc Diagn 1989;16:3-7.〕 and was later adapted for therapeutic procedures of coronary angioplasty by Kiemeneij and Laarman.〔Kiemeneij F, Laarman GJ, Odekerken D, Slagboom T, Wieken RV: A Randomized Comparison of Percutaneous Transluminal Coronary Angioplasty by the Radial, Brachial and Femoral Approaches: The Access Study JACC. 1997;29:1269-75.〕
In India, the transradial approach was modified by Tejas Patel by the design of PATEL catheter which made the approach quicker and easier for the Asian arteries which were difficult to be accessed by traditional catheters used in the west.
In past few years, transradial access for coronary intervention has become increasingly popular. The most advantageous aspect is very low access-site bleeding complications even with aggressive use of anticoagulation and antiplatelet therapies.〔Kiemeneij F, Laarman GJ, Odekerken D, et al. A Randomized comparison of percutaneous transluminal coronary angioplasty by the radial, brachial and femoral approaches: The ACCESS study. J Am Coll Cardiol 1997;29:1269–1275.〕〔Pierfrancesco Agostoni, Giuseppe G. L. Biondi-Zoccai, M. Luisa De Benedictis, Stefano Rigattieri, Marco Turri, Maurizio Anselmi, Corrado Vassanelli, Piero Zardini, Yves Louvard, and Martial Hamon. Radial versus femoral approach for percutaneous coronary diagnostic and interventional procedures: Systematic overview and meta-analysis of randomized trials. J. Am. Coll. Cardiol., Jul 2004; 44: 349 - 356.〕 During the angioplasty and stent procedures patient's are given therapeutic (high) doses of anticoagulation (blood thinners) and platelet inhibiting medications.
抄文引用元・出典: フリー百科事典『 ウィキペディア（Wikipedia）』
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