Author + information
- Steven Feld, MD⁎ ()
- ↵⁎Heart and Vascular Diagnostic Clinic, 1111 West Frank, Suite 202, Lufkin, Texas 75904
I was trained with femoral catheterization techniques and found catheterization from the right radial artery a frustrating experience. Specialized catheters were of no avail in reducing excessive fluoroscopic time or providing the guide catheter support that I was accustomed to from the femoral approach. I nearly abandoned the radial technique. I then chose to cannulate the left radial artery from the left side of the patient with the hole in the drape typically reserved for left femoral access. As a right-handed operator, I position myself between the patient and his abducted left arm. After obtaining radial access, we remove the left arm from the arm board and slide the left wrist and drape together, placing the pronated left arm comfortably over the left femoral region. I return to the right side of the patient and proceed with cardiac catheterization from the left radial artery as I would from the left femoral artery, with 1 minor difference: I begin with a Judkin's curve that is a one-half-size less than I would typically use from the femoral approach. I was surprised to learn from the excellent summary of current transradial practice by Bertrand et al. (1) that “the large majority (89.4%) of operators use the right radial artery as the initial side.” Perhaps, this simple technique might lead others comfortable with the femoral approach to consider a much less demanding transition to using the radial artery for cardiac catheterization and intervention. Potential advantages of the radial technique include comfort, safety, and early discharge, including outpatient angioplasty for uncomplicated procedures.
- American College of Cardiology Foundation