Use of the Sheathless Eaucath Is an Effective Strategy to Overcome Resistant Severe Radial Spasm
Objectives. We aimed to assess the effectiveness of the sheathless Eaucath guiding catheter (SEGC) in overcoming severe spasm. Background. Radial spasm is a frequent challenge in transradial access (TRA) and can be difficult to manage. Methods. We performed a prospective observational study of 1000...
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Published in | Journal of interventional cardiology Vol. 2023; pp. 2434516 - 6 |
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Format | Journal Article |
Language | English |
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22.02.2023
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Abstract | Objectives. We aimed to assess the effectiveness of the sheathless Eaucath guiding catheter (SEGC) in overcoming severe spasm. Background. Radial spasm is a frequent challenge in transradial access (TRA) and can be difficult to manage. Methods. We performed a prospective observational study of 1000 consecutive patients undergoing coronary angiography with or without percutaneous coronary intervention. Patients with primary transfemoral access (TFA) or primary use of a sheathless guide catheter were excluded. Patients who developed angiographically confirmed severe spasm were treated with further sedation and vasodilators. If the conventional catheter would still not advance, it was exchanged for a SEGC. The primary endpoint was the successful passage of the SEGC through the radial with successful engagement of the coronary artery in patients with resistant severe spasm. Results. Primary TFA access was used in 58 (5.8%) and primary radial access with a SEGC in 44 (4.4%) patients. Of the remaining 898 patients, 888 (98.9%) had a radial sheath successfully inserted. Of these, 49 (5.5%) developed severe radial spasm with inability to advance the catheter. Following treatment with additional sedation and vasodilators, the severe spasm resolved in 5 (10.2%) patients. Passage of a SEGC was attempted in the remaining 44 patients with resistant severe spasm. Passage of the SEGC and engagement of coronary arteries were successful in all cases. There were no complications related to use of the SEGC. Conclusions. Our findings suggest that use of the SEGC for resistant severe spasm is highly effective, safe, and may reduce the need for conversion to TFA. |
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AbstractList | We aimed to assess the effectiveness of the sheathless Eaucath guiding catheter (SEGC) in overcoming severe spasm.ObjectivesWe aimed to assess the effectiveness of the sheathless Eaucath guiding catheter (SEGC) in overcoming severe spasm.Radial spasm is a frequent challenge in transradial access (TRA) and can be difficult to manage.BackgroundRadial spasm is a frequent challenge in transradial access (TRA) and can be difficult to manage.We performed a prospective observational study of 1000 consecutive patients undergoing coronary angiography with or without percutaneous coronary intervention. Patients with primary transfemoral access (TFA) or primary use of a sheathless guide catheter were excluded. Patients who developed angiographically confirmed severe spasm were treated with further sedation and vasodilators. If the conventional catheter would still not advance, it was exchanged for a SEGC. The primary endpoint was the successful passage of the SEGC through the radial with successful engagement of the coronary artery in patients with resistant severe spasm.MethodsWe performed a prospective observational study of 1000 consecutive patients undergoing coronary angiography with or without percutaneous coronary intervention. Patients with primary transfemoral access (TFA) or primary use of a sheathless guide catheter were excluded. Patients who developed angiographically confirmed severe spasm were treated with further sedation and vasodilators. If the conventional catheter would still not advance, it was exchanged for a SEGC. The primary endpoint was the successful passage of the SEGC through the radial with successful engagement of the coronary artery in patients with resistant severe spasm.Primary TFA access was used in 58 (5.8%) and primary radial access with a SEGC in 44 (4.4%) patients. Of the remaining 898 patients, 888 (98.9%) had a radial sheath successfully inserted. Of these, 49 (5.5%) developed severe radial spasm with inability to advance the catheter. Following treatment with additional sedation and vasodilators, the severe spasm resolved in 5 (10.2%) patients. Passage of a SEGC was attempted in the remaining 44 patients with resistant severe spasm. Passage of the SEGC and engagement of coronary arteries were successful in all cases. There were no complications related to use of the SEGC.ResultsPrimary TFA access was used in 58 (5.8%) and primary radial access with a SEGC in 44 (4.4%) patients. Of the remaining 898 patients, 888 (98.9%) had a radial sheath successfully inserted. Of these, 49 (5.5%) developed severe radial spasm with inability to advance the catheter. Following treatment with additional sedation and vasodilators, the severe spasm resolved in 5 (10.2%) patients. Passage of a SEGC was attempted in the remaining 44 patients with resistant severe spasm. Passage of the SEGC and engagement of coronary arteries were successful in all cases. There were no complications related to use of the SEGC.Our findings suggest that use of the SEGC for resistant severe spasm is highly effective, safe, and may reduce the need for conversion to TFA.ConclusionsOur findings suggest that use of the SEGC for resistant severe spasm is highly effective, safe, and may reduce the need for conversion to TFA. Objectives. We aimed to assess the effectiveness of the sheathless Eaucath guiding catheter (SEGC) in overcoming severe spasm. Background. Radial spasm is a frequent challenge in transradial access (TRA) and can be difficult to manage. Methods. We performed a prospective observational study of 1000 consecutive patients undergoing coronary angiography with or without percutaneous coronary intervention. Patients with primary transfemoral access (TFA) or primary use of a sheathless guide catheter were excluded. Patients who developed angiographically confirmed severe spasm were treated with further sedation and vasodilators. If the conventional catheter would still not advance, it was exchanged for a SEGC. The primary endpoint was the successful passage of the SEGC through the radial with successful engagement of the coronary artery in patients with resistant severe spasm. Results. Primary TFA access was used in 58 (5.8%) and primary radial access with a SEGC in 44 (4.4%) patients. Of the remaining 898 patients, 888 (98.9%) had a radial sheath successfully inserted. Of these, 49 (5.5%) developed severe radial spasm with inability to advance the catheter. Following treatment with additional sedation and vasodilators, the severe spasm resolved in 5 (10.2%) patients. Passage of a SEGC was attempted in the remaining 44 patients with resistant severe spasm. Passage of the SEGC and engagement of coronary arteries were successful in all cases. There were no complications related to use of the SEGC. Conclusions. Our findings suggest that use of the SEGC for resistant severe spasm is highly effective, safe, and may reduce the need for conversion to TFA. We aimed to assess the effectiveness of the sheathless Eaucath guiding catheter (SEGC) in overcoming severe spasm. Radial spasm is a frequent challenge in transradial access (TRA) and can be difficult to manage. We performed a prospective observational study of 1000 consecutive patients undergoing coronary angiography with or without percutaneous coronary intervention. Patients with primary transfemoral access (TFA) or primary use of a sheathless guide catheter were excluded. Patients who developed angiographically confirmed severe spasm were treated with further sedation and vasodilators. If the conventional catheter would still not advance, it was exchanged for a SEGC. The primary endpoint was the successful passage of the SEGC through the radial with successful engagement of the coronary artery in patients with resistant severe spasm. Primary TFA access was used in 58 (5.8%) and primary radial access with a SEGC in 44 (4.4%) patients. Of the remaining 898 patients, 888 (98.9%) had a radial sheath successfully inserted. Of these, 49 (5.5%) developed severe radial spasm with inability to advance the catheter. Following treatment with additional sedation and vasodilators, the severe spasm resolved in 5 (10.2%) patients. Passage of a SEGC was attempted in the remaining 44 patients with resistant severe spasm. Passage of the SEGC and engagement of coronary arteries were successful in all cases. There were no complications related to use of the SEGC. Our findings suggest that use of the SEGC for resistant severe spasm is highly effective, safe, and may reduce the need for conversion to TFA. |
Audience | Academic |
Author | Borrie, Andrew Harding, Scott A. Ranchord, Anil Raina, Aditya Fairley, Sarah |
AuthorAffiliation | Wellington Hospital, Wellington, New Zealand |
AuthorAffiliation_xml | – name: Wellington Hospital, Wellington, New Zealand |
Author_xml | – sequence: 1 givenname: Andrew orcidid: 0000-0003-0132-2178 surname: Borrie fullname: Borrie, Andrew organization: Wellington HospitalWellingtonNew Zealandthewellingtonhospital.com – sequence: 2 givenname: Aditya orcidid: 0000-0003-0944-2916 surname: Raina fullname: Raina, Aditya organization: Wellington HospitalWellingtonNew Zealandthewellingtonhospital.com – sequence: 3 givenname: Sarah orcidid: 0000-0001-9200-8218 surname: Fairley fullname: Fairley, Sarah organization: Wellington HospitalWellingtonNew Zealandthewellingtonhospital.com – sequence: 4 givenname: Anil surname: Ranchord fullname: Ranchord, Anil organization: Wellington HospitalWellingtonNew Zealandthewellingtonhospital.com – sequence: 5 givenname: Scott A. orcidid: 0000-0003-4282-4107 surname: Harding fullname: Harding, Scott A. organization: Wellington HospitalWellingtonNew Zealandthewellingtonhospital.com |
BackLink | https://www.ncbi.nlm.nih.gov/pubmed/36873570$$D View this record in MEDLINE/PubMed |
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Cites_doi | 10.1016/j.jacc.2012.06.017 10.1016/j.carrev.2011.11.003 10.1002/ccd.25163 10.1161/circulationaha.122.061527 10.1016/j.jcin.2010.03.009 10.1136/bmj.329.7463.443 10.1093/eurheartj/ehy394 10.1161/hcv.0000000000000035 10.1016/s0140-6736(11)60404-2 10.1002/ccd.10698 10.1136/hrt.2008.150474 10.1002/ccd.10586 10.1016/j.jcin.2009.05.026 10.1002/ccd.10202 10.1002/ccd.28619 10.1161/circinterventions.119.007386 10.1002/ccd.25082 10.1016/S0140-6736(18)31714-8 10.1016/s0140-6736(15)60292-6 10.1016/j.hlc.2014.12.165 |
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References | 11 S. Tehrani (14) 2015; 22 22 12 23 13 I. Kristić (10) 2011; 23 F.-J. Neumann (7) 2019; 40 15 16 17 19 S. Gunasekaran (18) 2009; 21 1 2 3 4 5 6 8 9 20 21 |
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Snippet | Objectives. We aimed to assess the effectiveness of the sheathless Eaucath guiding catheter (SEGC) in overcoming severe spasm. Background. Radial spasm is a... We aimed to assess the effectiveness of the sheathless Eaucath guiding catheter (SEGC) in overcoming severe spasm. Radial spasm is a frequent challenge in... We aimed to assess the effectiveness of the sheathless Eaucath guiding catheter (SEGC) in overcoming severe spasm.ObjectivesWe aimed to assess the... |
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SubjectTerms | Angiography Cardiac patients Care and treatment Catheters Coronary Angiography Coronary Vessels Humans Medical research Medicine, Experimental Percutaneous Coronary Intervention Transluminal angioplasty Vasodilator Agents Vasodilators |
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Title | Use of the Sheathless Eaucath Is an Effective Strategy to Overcome Resistant Severe Radial Spasm |
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