Transradial Cardiac Catheterization Technique

Updated: Jan 24, 2014
  • Author: David H Adler, MD, FACC; Chief Editor: Eric H Yang, MD  more...
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Technique

Approach Considerations

The left or right radial artery can be used for cardiac catheterization. The standard equipment setup in most catheterization laboratories facilitates right radial artery access, which tends to be used more frequently.

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Transradial Catheterization

Under sterile conditions, the radial artery is accessed with a 20- to 21-gauge needle, and a 5F-6F sheath is advanced into the artery over a wire using the Seldinger technique.

Vasodilators (usually verapamil and nitroglycerin) are administered to reduce radial artery spasm. [57, 58]

Hydrophilic sheaths are generally used to minimize trauma to the radial artery. An anticoagulant (usually unfractionated heparin or bivalirudin) is given to prevent radial artery thrombosis. [59]

A guidewire is then advanced from the radial artery to the ascending aorta.

Catheters are advanced over the guidewire and used for coronary angiography and/or coronary intervention. Specialized catheters shaped to aid in engaging the coronary arteries from the transradial approach have been developed, although traditional coronary catheters can also be used.

After the procedure, the sheath is removed and pressure is held over the arteriotomy site to achieve hemostasis. Several devices have been developed to assist in maintaining pressure on the wrist; most are bands that allow easy modification of hemostatic pressure.

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