Watch and Learn: How to go Left Radial
Left Radial approach has several advantages:
- 1. Those with previous CABG
- 2. Those who are older than 70-75 or long standing hypertension have problems with turning catheters thru a tortuous subclavian and rotated aorta (Sciahbasi et al Am Heart J 2011;161:172-179. Dehgani et al JACC Intv 2009;1057:1057-64. Freixa et al Cathet Cardio Inteven 2012;80:267-72. Soo Cha et al. Am J Cardiol 2003;92:1220-22)
- 3. Avoid use right radial in those where it is the dominant hand
- 4. Lower flouroscopy time compared to right radial access (Dominici et al. Heart 2013;99:480-484. Sciahbasi et al Am Heart J 2011;161:172-179)
- 5. For primary PCI (in acute coronary syndrome), guidelines have specified, "An a priori left radial approach should be strongly considered in those with patients undergoing transradial primary PCI who are post-CABG with a pedicle LIMA graft". (Rao, S et al. Catheterization and Cardiovascular Interventions, 2013; 83(2): 228-236)
- 6. For primary PCI (in acute coronary syndrome), guidelines have specified, "An a priori left radial approach should be considered in patients undergoing transradial primary PCI who are older than age 75 years or who are 5'5" or shorter". (Rao, S et al. Catheterization and Cardiovascular Interventions, 2013; 83(2): 228