Mamas Mamas m.mamas@keele.ac.uk
Transradial Approach for Left Ventricular Endomyocardial Biopsy
Mamas
Authors
Abstract
Background
Left ventricular endomyocardial biopsy (LV-EMB) may offer a superior diagnostic yield compared with right ventricular endomyocardial biopsy (RV-EMB) in conditions predominantly affecting the LV but is underused compared with 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 multicentre 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, and 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).
Conclusions
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.
Acceptance Date | May 8, 2018 |
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Publication Date | Oct 1, 2018 |
Journal | Canadian Journal of Cardiology |
Print ISSN | 0828-282X |
Publisher | Elsevier |
Pages | 1283-1288 |
DOI | https://doi.org/10.1016/j.cjca.2018.05.007 |
Keywords | transradial, radial, endomyocardial, biopsy, cardiomyopathy |
Publisher URL | https://doi.org/10.1016/j.cjca.2018.05.007 |
Files
TR-LV EMB-CJC-D-18-00053-R2-2018-05-04-Clean Copy.docx
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Publisher Licence URL
https://creativecommons.org/licenses/by-nc-nd/4.0/
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