Transradial left ventricular endomyocardial biopsy: assessment of safety and efficacy
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We aimed at assessing the safety and efficacy of a systematic transradial approach for left ventricular endomyocardial biopsy using a new hydrophilic sheathless guiding catheter.
Methods and results
Forty-two consecutive patients were included. The transradial success rate was 98 % (41 of 42). In one case, cross over to femoral access due to irreversible spasm of the right radial artery was necessary. No radial spasm was observed in the other 41 patients. Depending on the indication, several other procedures, such as coronary angiography or ventricular angiography, were additionally performed through the same transradial access site. Median fluoroscopy time was 7.9 min. The mean dose area product was 1867 cGy × cm2. All biopsy samples were graded as good or excellent quality. No patient had any complications. Immediate post-procedural ambulation could be achieved in all patients. Radial artery patency was confirmed by duplex sonography 24 h after removal of the guide.
The present study demonstrates safety and efficacy of a systematic transradial access for left ventricular EMB using a highly hydrophilic sheathless guiding catheter. This is of clinical importance since this new technique may overcome critical limitations of the common approach.
KeywordsTransradial access Transfemoral access Endomyocardial biopsy Complications Sheathless guiding catheter Left ventricular biopsy Myocardial disease
Intracoronary acetylcholine testing
Fractional flow reserve
Left ventricular angiogram
Left ventricular ejection fraction
Percutaneous coronary angioplasty
Right heart catheterization
We are indebted to Mrs. Nermina Soskic, BS for helping with the data collection. This work was funded in part by the Robert Bosch Foundation (clinical research Grant for inflammatory heart disease KKF-11-18, KKF-13-2).
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