Reduction of catheter kinks and knots via radial approach.
Reduction of catheter kinks and knots via radial approach.
- 2018
Available online from MWHC library: 1996 - present, Available in print through MWHC library: 1996 - 2006
Copyright (c) 2018 Wiley Periodicals, Inc. Coronary angiography and percutaneous coronary intervention using the radial approach are becoming more frequent. Pronounced guide catheter manipulation in cases with tortuous access routes may lead to severe catheter kinking or knotting. The purpose of this review article is to present several techniques to resolve radial access catheter knots and kinks. First, simple maneuvers such as gentle traction, rotation, and guidewire advancement can often resolve minor kinking; however, complex loops and kinks are often not reversible with these simple maneuvers. Second, fixing the distal catheter tip using external compression, encasing the knot with a larger sheath, or untwisting the knot with hydraulic pressure can be useful. Finally, internal fixation by grasping the kinked catheter with a snare introduced via the femoral artery allows both ends of the catheter to be rotated in opposite directions to untwist the catheter for safe removal.
English
1522-1946
10.1002/ccd.27623 [doi]
*Cardiac Catheterization/is [Instrumentation]
*Cardiac Catheters
*Catheterization, Peripheral/mt [Methods]
*Coronary Angiography/is [Instrumentation]
*Device Removal/mt [Methods]
*Equipment Failure
*Percutaneous Coronary Intervention/is [Instrumentation]
*Radial Artery
Cardiac Catheterization/ae [Adverse Effects]
Catheterization, Peripheral/ae [Adverse Effects]
Coronary Angiography/ae [Adverse Effects]
Equipment Design
Humans
Percutaneous Coronary Intervention/ae [Adverse Effects]
Radial Artery/dg [Diagnostic Imaging]
MedStar Heart & Vascular Institute
Case Reports
Available online from MWHC library: 1996 - present, Available in print through MWHC library: 1996 - 2006
Copyright (c) 2018 Wiley Periodicals, Inc. Coronary angiography and percutaneous coronary intervention using the radial approach are becoming more frequent. Pronounced guide catheter manipulation in cases with tortuous access routes may lead to severe catheter kinking or knotting. The purpose of this review article is to present several techniques to resolve radial access catheter knots and kinks. First, simple maneuvers such as gentle traction, rotation, and guidewire advancement can often resolve minor kinking; however, complex loops and kinks are often not reversible with these simple maneuvers. Second, fixing the distal catheter tip using external compression, encasing the knot with a larger sheath, or untwisting the knot with hydraulic pressure can be useful. Finally, internal fixation by grasping the kinked catheter with a snare introduced via the femoral artery allows both ends of the catheter to be rotated in opposite directions to untwist the catheter for safe removal.
English
1522-1946
10.1002/ccd.27623 [doi]
*Cardiac Catheterization/is [Instrumentation]
*Cardiac Catheters
*Catheterization, Peripheral/mt [Methods]
*Coronary Angiography/is [Instrumentation]
*Device Removal/mt [Methods]
*Equipment Failure
*Percutaneous Coronary Intervention/is [Instrumentation]
*Radial Artery
Cardiac Catheterization/ae [Adverse Effects]
Catheterization, Peripheral/ae [Adverse Effects]
Coronary Angiography/ae [Adverse Effects]
Equipment Design
Humans
Percutaneous Coronary Intervention/ae [Adverse Effects]
Radial Artery/dg [Diagnostic Imaging]
MedStar Heart & Vascular Institute
Case Reports