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Drieghe B, De Buyzere M, Bové T, De Backer T. Interventions for renal artery stenosis: Appraisal of novel physiological insights and procedural techniques to improve clinical outcome. Catheter Cardiovasc Interv 2024; 104:285-299. [PMID: 38837309 DOI: 10.1002/ccd.31117] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/29/2023] [Revised: 05/07/2024] [Accepted: 05/25/2024] [Indexed: 06/07/2024]
Abstract
Randomized clinical trials failed to show additional benefit of renal artery stenting on top of medical therapy. Instead of writing an obituary on renal artery stenting, we try to explain these disappointing results. A transstenotic pressure gradient is needed to reduce renal perfusion and to activate the renin-angiotensin-aldosterone system. In only a minority of patients included in trials, a transstenotic pressure gradient is measured and reported. Like the coronary circulation, integration of physiological lesion assessment will allow to avoid stenting of non-significant lesions and select those patients that are most likely to benefit from renal artery stenting. Renal artery interventions are associated with peri-procedural complications. Contemporary techniques, including radial artery access, no-touch technique to engage the renal ostium and the use of embolic protection devices, will minimize procedural risk. Combining optimal patient selection and meticulous technique might lead to a netto clinical benefit when renal artery stenting is added to optimal medical therapy.
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Affiliation(s)
- Benny Drieghe
- Heart Center, University Hospital Gent, Gent, Belgium
| | | | - Thierry Bové
- Heart Center, University Hospital Gent, Gent, Belgium
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2
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Valenzuela TF, Schinstock E, Kohnle S, Latib A, Bliagos D, Tunev S, Iaizzo PA. Preclinical research performed on reanimated/perfused swine kidneys: The Visible Kidney™ methodologies. Physiol Rep 2023; 11:e15630. [PMID: 36878878 PMCID: PMC9988650 DOI: 10.14814/phy2.15630] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/14/2022] [Revised: 01/27/2023] [Accepted: 02/09/2023] [Indexed: 03/08/2023] Open
Abstract
Preclinical research remains the essential platform in the development and optimization of medical therapies and advancements in translational medicines. However, specifically to animal research, federal laws, and institutional policies require investigators to apply the principles of the 3R's (replacement, reduction, and refinement). The concept of benchtop models utilizing isolated organs, in which multiple variables can be controlled to recreate human function, has been innovative advancements in preclinical research models that adhere to these principles. More specifically, isolated perfused kidney (IPK) models have been invaluable preclinical tools that have led to numerous advancements over the decades, including understanding renal physiology, pharmacologic therapies, and improvements in renal transplantation. However, pre-existing IPK models are not without their own limitations, leaving areas for improvement. An isolated perfused kidney apparatus was designed to best recreate human use conditions as a preclinical tool. Porcine renal blocks were chosen over the more commonly used rodent models, due to their greater similarities to human anatomies. Sixteen porcine kidney pairs obtained en bloc were extracted and placed onto an apparatus where aortic flows, pressures, and overall systemic temperatures were controlled. Organ viability was assessed in 10 renal blocks (n = 8 fresh and n = 2 previously frozen specimens) via both urinary flows and compositions at timepoints up to 180 min. Multimodality imaging, which included fluoroscopy, ultrasound, optical coherence tomography (OCT), and video scopes, was also employed to capture internal and external images to determine renal artery orientations and dimensions. Anatomical measurements and viability assessments of porcine renal blocks were successfully achieved in our perfusion model. Renal main artery diameters averaged smaller in our sample size than in human anatomy while also having more superior takeoff angles. Yet, the average lengths of each main segment were comparable to human anatomy: 32.09 ± 7.97 mm and 42.23 ± 7.33 mm in the left and right renal main artery, respectively. Urine production and urine composition of the fresh renal blocks, when compared to the frozen blocks and baseline perfusate, showed kidney viabilities of up to 3 h via excretion and retention of various metabolites. In this paper, we described a protocol for an isolated perfused kidney apparatus using large mammalian renal blocks. We believe this protocol to be an improvement from similar pre-existing models in better representing human physiologic function while allowing for multimodal imaging. The resulting Visible Kidney™ preclinical model, which has shown viability after isolation and reperfusion, can be a fast and reliable tool for the development of medical devices while also reducing the unnecessary use of animals for research.
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Affiliation(s)
| | | | - Samantha Kohnle
- The Department of Surgery's Visible Heart® Laboratories and the Institute for Engineering in MedicineUniversity of MinnesotaMinneapolisMinnesotaUSA
| | - Azeem Latib
- Montefiore Medical Center, Albert Einstein College of MedicineThe BronxNew YorkUSA
| | - Dimitrios Bliagos
- Montefiore Medical Center, Albert Einstein College of MedicineThe BronxNew YorkUSA
| | | | - Paul A. Iaizzo
- The Department of Surgery's Visible Heart® Laboratories and the Institute for Engineering in MedicineUniversity of MinnesotaMinneapolisMinnesotaUSA
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3
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Villela MA, Sanina C, Pyo R. Vascular Access Site Complications. Interv Cardiol 2022. [DOI: 10.1002/9781119697367.ch27] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/09/2022] Open
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4
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Renal Arteriography via Radial Artery Access with a 125 cm Long Angiographic Catheter. BIOMED RESEARCH INTERNATIONAL 2021; 2021:5564462. [PMID: 33977105 PMCID: PMC8087463 DOI: 10.1155/2021/5564462] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 02/09/2021] [Revised: 03/26/2021] [Accepted: 04/19/2021] [Indexed: 11/17/2022]
Abstract
A 125 cm long catheter makes it possible to perform renal arteriography via radial artery, but its feasibility and safety remain unclear. Our study recruited 1,323 patients grouped by two different vascular accesses to renal arteriography, i.e., femoral artery access and radial artery access. The success rate of angiography was 100% in both groups. Differential analysis showed that the overall complication incidence of radial artery access group was significantly lower (2.5% for radial artery access vs. 4.8% for femoral artery access, p = 0.03). From this study, we suggest that using the 125 cm angiographic catheter to perform renal arteriography via radial artery access is feasible and safe.
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Contemporary Use of Radial to Peripheral Access for Management of Peripheral Artery Disease. CURRENT TREATMENT OPTIONS IN CARDIOVASCULAR MEDICINE 2021. [DOI: 10.1007/s11936-020-00895-x] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
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6
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Aurigemma C, Osama S, Burzotta F, Antonio LM, Giampaolo N, Porto I, Russo G, Verdirosi D, Trani C. Usefulness of sheathless guiding catheters in patients with upper extremity vascular anomalies: Sheathless catheters in upper vascular anomalies. ASIAINTERVENTION 2020; 6:43-49. [PMID: 34912983 PMCID: PMC8525726 DOI: 10.4244/aij-d-19-00024] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Received: 06/08/2019] [Accepted: 07/10/2020] [Indexed: 02/06/2024]
Abstract
AIMS The transradial approach (TRA) reduces hospitalisation and access-site complications as compared to the transfemoral approach. Nevertheless, the TRA technical failure rate is significantly higher compared to the transfemoral approach. The high failure rate of TRA is due to a series of factors. In particular, a wide range of anatomic vascular variants hindering procedural success may be present in patients undergoing TRA procedures. METHODS AND RESULTS In our retrospective observational study, 1,596 consecutive patients with upper limb vascular anomalies underwent TRA between January 2006 and July 2017. We evaluate the usefulness of the sheathless guiding catheter system (SG) as compared to the conventional guiding catheter (CG). The primary study endpoint was the "procedural success" defined as successful transradial procedure (both selective cannulation of the coronary ostium in the diagnostic procedure and successful stent delivery in the interventional procedure) without access change. All SG procedures were successful, whereas only 1,274 (86%) CG procedures were successfully performed (p=0.0001). At multivariable analysis, age (p=0.001) and sheathless catheter use (p=0.001) were independent predictors of procedural success. CONCLUSIONS The sheathless GC is a safe and useful system not only for small radial access but also in the presence of upper vascular anomalies and it can be used in PCI and diagnostic procedures.
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Affiliation(s)
- Cristina Aurigemma
- Institute of Cardiology, Fondazione Policlinico Universitario A. Gemelli IRCSS, Rome, Italy
| | - Shoeib Osama
- Cardiology Department, Tanta University, Tanta, Egypt
| | - Francesco Burzotta
- Institute of Cardiology, Fondazione Policlinico Universitario A. Gemelli IRCSS, Rome, Italy
- Institute of Cardiology Università Cattolica del Sacro Cuore, Rome, Italy
| | - Leone Maria Antonio
- Institute of Cardiology, Fondazione Policlinico Universitario A. Gemelli IRCSS, Rome, Italy
| | - Niccoli Giampaolo
- Institute of Cardiology, Fondazione Policlinico Universitario A. Gemelli IRCSS, Rome, Italy
| | - Italo Porto
- Institute of Cardiology, Fondazione Policlinico Universitario A. Gemelli IRCSS, Rome, Italy
| | - Giulio Russo
- Institute of Cardiology, Fondazione Policlinico Universitario A. Gemelli IRCSS, Rome, Italy
| | - Diana Verdirosi
- Institute of Cardiology, Fondazione Policlinico Universitario A. Gemelli IRCSS, Rome, Italy
| | - Carlo Trani
- Institute of Cardiology, Fondazione Policlinico Universitario A. Gemelli IRCSS, Rome, Italy
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Prince M, Tafur JD, White CJ. When and How Should We Revascularize Patients With Atherosclerotic Renal Artery Stenosis? JACC Cardiovasc Interv 2020; 12:505-517. [PMID: 30898248 DOI: 10.1016/j.jcin.2018.10.023] [Citation(s) in RCA: 58] [Impact Index Per Article: 14.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/12/2018] [Revised: 09/19/2018] [Accepted: 10/01/2018] [Indexed: 01/21/2023]
Abstract
Atherosclerotic renal artery stenosis is the leading cause of secondary hypertension and may lead to resistant (refractory) hypertension, progressive decline in renal function, and cardiac destabilization syndromes (pulmonary edema, recurrent heart failure, or acute coronary syndromes) despite guideline-directed medical therapy. Although randomized controlled trials comparing medical therapy with medical therapy and renal artery stenting have failed to show a benefit for renal artery stenting, according to comparative effectiveness reviews by the Agency for Healthcare Research and Quality, the trials may not have enrolled patients with the most severe atherosclerotic renal artery stenosis, who would be more likely to benefit from renal stenting. Because of limitations of conventional angiography, it is critical that the hemodynamic severity of moderately severe (50% to 70%) atherosclerotic renal artery stenosis lesions be confirmed on hemodynamic measurement. The authors review techniques to optimize patient selection, to minimize procedural complications, and to facilitate durable patency of renal stenting. The authors also review the current American College of Cardiology and American Heart Association guidelines and the Society for Cardiovascular Angiography and Interventions appropriate use criteria as they relate to renal stenting.
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Affiliation(s)
- Marloe Prince
- Department of Cardiology at Ochsner Clinic Foundation, New Orleans, Louisiana.
| | - Jose D Tafur
- Department of Cardiology at Ochsner Clinic Foundation, New Orleans, Louisiana
| | - Christopher J White
- Department of Cardiology at Ochsner Clinic Foundation, New Orleans, Louisiana
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8
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Caputo RP. Editorial: Transradial Access - to the Heart of the Matter and More. CARDIOVASCULAR REVASCULARIZATION MEDICINE 2020; 21:227-229. [PMID: 32199666 DOI: 10.1016/j.carrev.2020.01.022] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
Affiliation(s)
- Ronald P Caputo
- St. Joseph's Cardiovascular Specialists, 4939 Brittonfield Pkwy, Suite 202, East Syracuse, NY 13058.
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Goldsweig AM, Secemsky EA. Vascular Access and Closure for Peripheral Arterial Intervention. Interv Cardiol Clin 2020; 9:117-124. [PMID: 32147114 DOI: 10.1016/j.iccl.2019.11.001] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
Abstract
Peripheral arterial interventions require safe and effective vascular access and closure. The sites, techniques, and equipment used may vary depending on patient and procedural factors. To minimize the risk of procedural complications, arterial access should use micropuncture technique, ultrasound and fluoroscopic guidance, a compressible arterial access site, and the smallest diameter sheath necessary. Hemostasis at an arteriotomy site may be achieved by manual compression, device-mediated compression, an intravascular closure device, or an extravascular closure device. Although closure devices improve patient comfort and expedite hemostasis, they have not been shown to reduce complications in comparison with compression.
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Affiliation(s)
- Andrew M Goldsweig
- Division of Cardiovascular Medicine, University of Nebraska Medical Center, 982265 Nebraska Medical Center, Omaha, NE 68198, USA.
| | - Eric A Secemsky
- Division of Cardiovascular Medicine, Harvard Medical School, Boston, MA, USA
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10
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George JM, Price LZ, Korayem AH, Marin ML, Faries PL, Tadros RO. Transradial renal salvage after complex endovascular aneurysm repair complicated by left renal artery thrombosis. JOURNAL OF VASCULAR SURGERY CASES INNOVATIONS AND TECHNIQUES 2019; 5:239-242. [PMID: 31304431 PMCID: PMC6600808 DOI: 10.1016/j.jvscit.2018.12.015] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 10/26/2018] [Accepted: 12/26/2018] [Indexed: 11/27/2022]
Abstract
Transradial access has been used for percutaneous coronary interventions with success; however, there is limited literature on its use for visceral stenting in the setting of complex endovascular aneurysm repair. We present a case of transradial left renal salvage after renal artery thrombosis in the setting of complex endovascular aneurysm repair.
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Affiliation(s)
- Justin M George
- Division of Vascular Surgery, Department of Surgery, The Icahn School of Medicine at Mount Sinai, New York, NY
| | - Lucyna Z Price
- Division of Vascular Surgery, Department of Surgery, The Icahn School of Medicine at Mount Sinai, New York, NY
| | - Adam H Korayem
- Division of Vascular Surgery, Department of Surgery, The Icahn School of Medicine at Mount Sinai, New York, NY
| | - Michael L Marin
- Division of Vascular Surgery, Department of Surgery, The Icahn School of Medicine at Mount Sinai, New York, NY
| | - Peter L Faries
- Division of Vascular Surgery, Department of Surgery, The Icahn School of Medicine at Mount Sinai, New York, NY
| | - Rami O Tadros
- Division of Vascular Surgery, Department of Surgery, The Icahn School of Medicine at Mount Sinai, New York, NY
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11
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Comparison of the transradial and transfemoral approach in treatment of chronic total occlusions with similar lesion characteristics. Anatol J Cardiol 2019; 19:319-325. [PMID: 29724974 PMCID: PMC6280270 DOI: 10.14744/anatoljcardiol.2018.02779] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/05/2023] Open
Abstract
Objective: There is limited data on the efficacy and the safety of the transradial approach (TRA) for percutaneous coronary intervention (PCI) of chronic total occlusion (CTO), particularly in comparison with the transfemoral approach (TFA) in lesions with similar complexity. Methods: We included 358 patients, who underwent elective CTO PCI between January 2012 and August 2017 and compared the radial (179 patients) and femoral (179 patients) approaches. The J-CTO score was similar in both groups (TRA, 2.5±1.3 vs. TFA, 2.8±1.4, n.s.). The endpoints analyzed included (i) the composite of all-cause death and nonfatal myocardial infarction (MI) and (ii) the composite safety endpoint of major adverse cardiovascular and cerebrovascular events (MACCEs), including death, MI, coronary perforation, contrast-induced nephropathy (CIN), bleeding at the vascular access site requiring transfusion, cardiac tamponade requiring pericardiocentesis, and periprocedural stroke. Results: Patients’ demographics, lesion location, lesion characteristics, and the proportion of antegrade vs. retrograde approach were similar in both groups. The procedural success rate of 96.4% in the radial group and 92.9% in the femoral group was comparable. The total fluoroscopy time (TRA, 42.4±15.7 min vs. TFA, 40.5±15.3 min, n.s.) and contrast medium use (TRA, 532.2±21.7 mL vs. TFA, 528.2±24.6 mL, n.s.) was similar in both groups. There was no in-hospital death or periprocedural MI in both groups. There were three coronary perforations in the TFA group, among them one with tamponade, and one coronary perforation the TRA group. Vascular access site complications (TRA, 0.01% vs. TFA, 0.02%) and CIN (TRA, 0.006% vs. TFA, 0.006%) were rare. One stroke as a result of the procedure was observed in the TFA group. No death was registered. Conclusion: The radial approach in CTO PCI was as fast and successful as the femoral approach, even in a complex lesion subset.
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12
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Stern JR, Ellozy SH. Transradial Delivery of a Renal Snorkel During Complex Endovascular Aortic Aneurysm Repair. Vasc Endovascular Surg 2017; 51:513-516. [PMID: 28774222 DOI: 10.1177/1538574417723158] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
Transradial access has been described in a variety of clinical contexts but has been rarely utilized for visceral artery interventions and during complex endovascular aortic aneurysm repair (EVAR) when upper extremity access is required. This is usually accomplished via brachial artery access, and although brachial access is generally safe and effective, radial access may offer some benefits with regard to patient comfort and potential complications. Here we report a case of successful delivery of a renal snorkel via a radial artery approach during EVAR. A 71-year-old man presented for endovascular repair of an asymptomatic abdominal aortic aneurysm. Anatomic limitations dictated the need for a left renal snorkel in order to augment the proximal seal zone. Via a right radial approach, a 6-Fr sheath and then a 6-mm iCast stent (Atrium Medical, Hudson, New Hampshire) were delivered into the left renal artery. Endovascular aortic aneurysm repair was then completed with a bifurcated Endurant stent graft (Medtronic, Fridley, Minnesota). The renal stent and aortic stent grafts were successfully deployed. Completion angiography demonstrated a patent left renal snorkel, with no evidence of endoleak. Hemostasis was achieved at the radial puncture site with no complications. This demonstrates the feasibility of radial artery access for the delivery of adjunctive stents during complex EVAR.
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Affiliation(s)
- Jordan R Stern
- 1 Division of Vascular and Endovascular Surgery, New York-Presbyterian Hospital, Weill Cornell Medicine, New York, NY, USA
| | - Sharif H Ellozy
- 1 Division of Vascular and Endovascular Surgery, New York-Presbyterian Hospital, Weill Cornell Medicine, New York, NY, USA
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13
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Abstract
Atherosclerotic renal artery stenosis is the leading cause of secondary hypertension; it can also cause progressive renal insufficiency and cardiovascular complications such as refractory heart failure and flash pulmonary edema. Medical therapy including risk factor modification, renin-angiotensin-aldosterone system antagonists, lipid lowering agents, and antiplatelet therapy is the first line of treatment in all patients. Patients with uncontrolled renovascular hypertension despite optimal medical therapy, ischemic nephropathy, and cardiac destabilization syndromes who have severe renal artery stenosis are likely to benefit from renal artery revascularization. Screening for renal artery stenosis can be done with Doppler ultrasonography, computed tomographic angiography and magnetic resonance angiography. Invasive physiologic measurements are useful to confirm the severity of renal hypoperfusion and therefore improve the selection patients likely to respond to renal artery revascularization. Primary patency exceeds 80% at 5 years and surveillance for in-stent restenosis can be done with periodic clinical, laboratory, and imaging follow-up.
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Jiang XJ, Dong H, Liang T, Zou YB, Xu B, Gao RL. First-in-man report of a novel dedicated radiofrequency catheter for renal denervation via the transulnar approach. EUROINTERVENTION 2016; 9:684-6. [PMID: 24169129 DOI: 10.4244/eijv9i6a111] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/23/2022]
Abstract
Renal denervation (RDN) has been shown to be safe and efficacious in reducing blood pressure in patients with resistant hypertension. In the present study, we describe a first-in-man report of the Iberis renal denervation device in a patient who underwent two RDN procedures: one via the femoral artery and one via the transulnar approach. RDN was performed in the patient's right renal artery using an Iberis catheter via the transulnar approach, as the transfemoral or transradial arteries could not be approached due to their anatomic constraints. In summary, RDN via the transulnar approach is feasible and represents a technical alternative solution in certain patients.
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Affiliation(s)
- Xiong-Jing Jiang
- Fu Wai Hospital, National Center for Cardiovascular Diseases of China, Beijing, China
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Burzotta F, Brancati MF, Porto I, Saffioti S, Aurigemma C, Niccoli G, Leone AM, Coluccia V, Crea F, Trani C. Comparison of Right and Left Upper Limb Arterial Variants in Patients Undergoing Bilateral Transradial Procedures. Circ Cardiovasc Interv 2015; 8:e002863. [DOI: 10.1161/circinterventions.115.002863] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Affiliation(s)
- Francesco Burzotta
- From the Institute of Cardiology, Catholic University of the Sacred Heart, Rome, Italy
| | | | - Italo Porto
- From the Institute of Cardiology, Catholic University of the Sacred Heart, Rome, Italy
| | - Silvia Saffioti
- From the Institute of Cardiology, Catholic University of the Sacred Heart, Rome, Italy
| | - Cristina Aurigemma
- From the Institute of Cardiology, Catholic University of the Sacred Heart, Rome, Italy
| | - Giampaolo Niccoli
- From the Institute of Cardiology, Catholic University of the Sacred Heart, Rome, Italy
| | - Antonio Maria Leone
- From the Institute of Cardiology, Catholic University of the Sacred Heart, Rome, Italy
| | - Valentina Coluccia
- From the Institute of Cardiology, Catholic University of the Sacred Heart, Rome, Italy
| | - Filippo Crea
- From the Institute of Cardiology, Catholic University of the Sacred Heart, Rome, Italy
| | - Carlo Trani
- From the Institute of Cardiology, Catholic University of the Sacred Heart, Rome, Italy
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16
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Truesdell AG, Delgado GA, Blakeley SW, Bachinsky WB. Transradial peripheral vascular intervention: challenges and opportunities. Interv Cardiol 2015. [DOI: 10.2217/ica.14.67] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/21/2022] Open
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18
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Tafur-Soto J, White CJ. Selecting patients likely to benefit from renal artery stenting. Interv Cardiol 2014. [DOI: 10.2217/ica.14.6] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/03/2023] Open
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Niccoli G, De Vita MR, Montone RA, Burzotta F, Trani C. Access route for coronary chronic total occlusion: femoral or radial approach? Interv Cardiol 2013. [DOI: 10.2217/ica.13.58] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/21/2022] Open
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Sanghvi K, Coppola J, Patel T. Cranio-caudal (transradial) approach for renal artery intervention. J Interv Cardiol 2013; 26:530-5. [PMID: 24033772 DOI: 10.1111/joic.12053] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/27/2022] Open
Abstract
This report describes the technique of transradial renal angiography and interventions. We illustrate the approach using typical case images. We believe cranio-caudal approach to the renal artery for diagnostic and therapeutic catheterization offers advantages over the traditional femoral approach.
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Affiliation(s)
- Kintur Sanghvi
- Deborah Heart and Lung Institute, Browns Mills, New Jersey
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21
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Burzotta F, De Vita M, Lefevre T, Tommasino A, Louvard Y, Trani C. Radial approach for percutaneous coronary interventions on chronic total occlusions: Technical issues and data review. Catheter Cardiovasc Interv 2013; 83:47-57. [DOI: 10.1002/ccd.25118] [Citation(s) in RCA: 30] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Revised: 06/23/2013] [Accepted: 06/27/2013] [Indexed: 11/10/2022]
Affiliation(s)
- Francesco Burzotta
- Institute of Cardiology; , Catholic University of Sacred Heart; Rome Italy
| | - Maria De Vita
- Interventional Cardiology; Morgagni-Pierantoni Hospital; Forlì Italy
| | - Thierry Lefevre
- Interventional Cardiology; Istitut Cardiovasculaire Paris Sud; Massy France
| | | | - Yves Louvard
- Interventional Cardiology; Istitut Cardiovasculaire Paris Sud; Massy France
| | - Carlo Trani
- Institute of Cardiology; , Catholic University of Sacred Heart; Rome Italy
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22
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Takeshita S, Matsumi J, Saito S. Renal artery intervention using a virtual 4.5-Fr guiding catheter. Catheter Cardiovasc Interv 2012; 81:1043-6. [PMID: 22581581 DOI: 10.1002/ccd.24484] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/21/2011] [Revised: 04/13/2012] [Accepted: 05/05/2012] [Indexed: 11/08/2022]
Abstract
A 6.5-Fr guiding catheter (Parent Plus 45, Medikit, Tokyo, Japan), composed of a hydrophilic sheathless guiding catheter and a dilator, has recently been developed for the treatment of renal artery stenosis. Because of its unique sheathless configuration, its outer diameter is comparable to that of a conventional 4.5-Fr introducer sheath, with the inner diameter being close in size to a 6.5-Fr guiding catheter. These features allow this sheathless system to be used as the sole guiding catheter while the arterial damage at the puncture site remains equivalent to that of a 4.5-Fr introducer sheath. We thus call this novel sheathless guiding catheter a virtual 4.5-Fr system. To demonstrate the potential of this virtual 4.5-Fr system, we report a case of renal artery stenosis successfully treated via the transradial route. This virtual 4.5-Fr system may become a viable alternative to conventional guiding catheters, and provide a favorable impact upon vascular access complications and patient morbidity.
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Affiliation(s)
- Satoshi Takeshita
- Department of Cardiology and Catheterization Laboratory, Shonan Kamakura General Hospital, Kamakura, Japan.
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23
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Burzotta F, Brancati MF, Trani C, Tommasino A, Porto I, Niccoli G, Leone AM, Coluccia V, Di Noi P, Crea F. Impact of radial-to-aorta vascular anatomical variants on risk of failure in trans-radial coronary procedures. Catheter Cardiovasc Interv 2012; 80:298-303. [DOI: 10.1002/ccd.24360] [Citation(s) in RCA: 22] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/18/2011] [Revised: 12/21/2011] [Accepted: 02/01/2012] [Indexed: 11/11/2022]
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Caputo RP, Tremmel JA, Rao S, Gilchrist IC, Pyne C, Pancholy S, Frasier D, Gulati R, Skelding K, Bertrand O, Patel T. Transradial arterial access for coronary and peripheral procedures: Executive summary by the transradial committee of the SCAI. Catheter Cardiovasc Interv 2011; 78:823-39. [PMID: 21544927 DOI: 10.1002/ccd.23052] [Citation(s) in RCA: 221] [Impact Index Per Article: 17.0] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/10/2011] [Accepted: 02/13/2011] [Indexed: 01/21/2023]
MESH Headings
- Angioplasty, Balloon, Coronary/adverse effects
- Angioplasty, Balloon, Coronary/methods
- Angioplasty, Balloon, Coronary/standards
- Cardiac Catheterization/adverse effects
- Cardiac Catheterization/methods
- Cardiac Catheterization/standards
- Cardiovascular Diseases/diagnostic imaging
- Cardiovascular Diseases/therapy
- Catheterization, Peripheral/adverse effects
- Catheterization, Peripheral/methods
- Catheterization, Peripheral/standards
- Clinical Competence
- Coronary Angiography/adverse effects
- Coronary Angiography/methods
- Coronary Angiography/standards
- Credentialing
- Endovascular Procedures/adverse effects
- Endovascular Procedures/methods
- Endovascular Procedures/standards
- Humans
- Patient Selection
- Radial Artery
- Risk Assessment
- Risk Factors
- Societies, Medical
- Treatment Outcome
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Affiliation(s)
- Ronald P Caputo
- St. Joseph's Hospital, S.U.N.Y. Upstate Medical School, Syracuse, New York 13203, USA.
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Burzotta F, Trani C, De Vita M, Crea F. A new operative classification of both anatomic vascular variants and physiopathologic conditions affecting transradial cardiovascular procedures. Int J Cardiol 2010; 145:120-2. [DOI: 10.1016/j.ijcard.2009.06.025] [Citation(s) in RCA: 11] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/12/2009] [Accepted: 06/15/2009] [Indexed: 10/20/2022]
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Affiliation(s)
- Christopher J White
- Department of Cardiovascular Diseases, John Ochsner Heart and Vascular Institute, Ochsner Clinic Foundation, 1514 Jefferson Highway, New Orleans, LA 70121, USA.
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27
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Burzotta F, De Vita M, Trani C. Transradial approach for percutaneous coronary interventions on chronic total occlusions. Interv Cardiol 2010. [DOI: 10.2217/ica.10.28] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/21/2022] Open
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28
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Trani C, Tommasino A, Giammarinaro M, Burzotta F, Coroleu SF, Rufini V, Mazzari MA, Porto I, Niccoli G, Leone AM, Mongiardo R, Gabrielli FA, Schiavoni G, Biamino G, Crea F. Renal artery stenting in patients with chronic ischemic heart disease. Catheter Cardiovasc Interv 2010; 76:26-34. [PMID: 20578190 DOI: 10.1002/ccd.22525] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/06/2022]
Affiliation(s)
- Carlo Trani
- Department of Cardiology, Catholic University of the Sacred Heart, Viale G. Rossini 74, Rome, Italy.
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