Author + information
- Received May 19, 2017
- Revision received July 3, 2017
- Accepted August 2, 2017
- Published online November 20, 2017.
- Yader Sandoval, MDa,b,
- M. Nicholas Burke, MDa,
- Angie S. Lobo, MDc,
- Daniel L. Lips, MDa,
- Arnold H. Seto, MD, MPAd,
- Ivan Chavez, MDa,
- Paul Sorajja, MDa,
- Mazen S. Abu-Fadel, MDe,
- Yale Wang, MDa,
- Anil Poulouse, MDa,
- Mario Gössl, MDa,
- Michael Mooney, MDa,
- Jay Traverse, MDa,
- David Tierney, MDb and
- Emmanouil S. Brilakis, MD, PhDa,∗ ()
- aMinneapolis Heart Institute, Abbott Northwestern Hospital, Minneapolis, Minnesota
- bDivision of Cardiology, Hennepin County Medical Center, Minneapolis, Minnesota
- cDepartment of Medical Education, Abbott Northwestern Hospital, Minneapolis, Minnesota
- dDivision of Cardiology, Department of Medicine, Veterans Affairs Long Beach Healthcare System and University of California, Irvine Medical Center, Long Beach, California
- eDepartment of Medicine, Cardiovascular Section, University of Oklahoma Health Sciences Center, Oklahoma City, Oklahoma
- ↵∗Address for correspondence:
Dr. Emmanouil S. Brilakis, Minneapolis Heart Institute and Minneapolis Heart Institute Foundation, Abbott Northwestern Hospital, 920 East 28th Street, #300, Minneapolis, Minnesota 55407.
Obtaining femoral and radial arterial access in the cardiac catheterization laboratory using state-of-the-art techniques is essential to optimize outcomes, patient satisfaction, and procedural efficiency. Although transradial access is increasingly used for coronary angiography and percutaneous coronary intervention, femoral access remains necessary for numerous procedures, many requiring large-bore access, including complex high-risk coronary interventions, structural procedures, and procedures involving mechanical circulatory support. For femoral access, contemporary access techniques should combine the use of fluoroscopy, ultrasound, micropuncture needle, femoral angiography, and vascular closure devices, when feasible. For radial access, ultrasound may reveal important anatomic features and expedite access. Despite randomized controlled trials supporting use of routine ultrasound guidance for femoral and/or radial arterial access, ultrasound remains underused in cardiac catheterization laboratories. This article reviews contemporary techniques to achieve optimal arterial access in the cardiac catheterization laboratory.
Dr. Brilakis has received consulting/speaker honoraria from Abbott Vascular, Amgen, Asahi, Cardiovascular Systems Inc., Elsevier, GE Healthcare, and Medicure; research support from Boston Scientific and Osprey; and his spouse was an employee of Medtronic. All other authors have reported that they have no relationships relevant to the contents of this paper to disclose.
- Received May 19, 2017.
- Revision received July 3, 2017.
- Accepted August 2, 2017.
- 2017 American College of Cardiology Foundation