Choudhury, T, Schäufele, TG, Lavi, S, Makino, K, Menezes, MN, Solomonica, A, Bertrand, OF, Gilchrist, IC, Mamas, MA ORCID: 0000-0001-9241-8890 and Bagur, R (2018) Transradial Approach for Left Ventricular Endomyocardial Biopsy. Canadian Journal of Cardiology. ISSN 1916-7075

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TR-LV EMB-CJC-D-18-00053-R2-2018-05-04-Clean Copy.docx - Accepted Version
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Abstract

Background: Left ventricular endomyocardial biopsy (LV-EMB) may offer a superior diagnostic yield compared to right ventricular endomyocardial biopsy (RV-EMB) in conditions predominantly affecting the LV but is underutilized as compared to RV-EMB. Despite the steep uptake of radial approach in coronary interventions, LV-EMB is usually performed via the femoral artery in contemporary practice. Therefore, the aim of this study was to assess the safety and feasibility of LV-EMB via a transradial approach in a multi-center registry.

Methods: One-hundred and two patients who underwent LV-EMB via transradial approach were included. Clinical characteristics, procedural, safety and feasibility data were evaluated. Results: LV-EMB was successfully performed via transradial access in 101 (99%) patients. Mild or moderate radial artery spasm occurred in 12 (12%) patients but only 1 (0.98%) patient required conversion to femoral access due to severe spasm. A total of 80 (78%) patients had LV-EMB via a sheathless guide catheter. Among those, 77 (96.3%) patients had 7.5-French sheathless guides while 3 (3.8%) patients had 8.5-French sheathless guides inserted. Radial sheaths were used in the remaining 22 patients, with 5-French sheaths in 21 of 22 patients. Heparin was administered to 93.1% of patients at a median dose of 5000 (3000-5000) IU. The remaining patients followed a provisional strategy upon patent hemostasis achievement. No access site related complications were reported. There were no major complications (pericardial tamponade, life-threatening arrhythmia, cerebrovascular accident or death).

Conclusion: In a population of patients undergoing transradial LV-EMB, the procedural success rate was high and showed an excellent safety profile. Further studies comparing transradial and transfemoral routes may help expand the use of transradial access for LV-EMB.

Item Type: Article
Additional Information: This is the accepted author manuscript (AAM). The final published version (version of record) is available online via Elsevier at https://doi.org/10.1016/j.cjca.2018.05.007- please refer to any applicable terms of use of the publisher.
Uncontrolled Keywords: transradial, radial, endomyocardial, biopsy, cardiomyopathy
Subjects: R Medicine > RC Internal medicine > RC666 Diseases of the circulatory (Cardiovascular) system
Divisions: Faculty of Medicine and Health Sciences > Institute for Science and Technology in Medicine
Depositing User: Symplectic
Date Deposited: 10 May 2018 10:13
Last Modified: 21 Aug 2018 09:38
URI: http://eprints.keele.ac.uk/id/eprint/4890

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