Читать книгу Interventional Cardiology - Группа авторов - Страница 78

High‐origin radial arteries (defined by their origin above the antecubital fossa) are the most commonly encountered radial artery anomaly occurring in 7% of patients undergoing radial angiography. These present problems during angiography due to their small caliber and often‐tortuous course making them prone to spasm. Nevertheless, using a coronary wire to navigate the segments and small hydrophilic coated catheters, the procedure can be completed successfully from the access site in over 95% of cases [25]. In the case of spasm due to inadvertent access through a tiny accessory radial branch (origin above cubital fossa), if a small catheter passes then a 0.035" exchange length wire can be postioned in the ascending aorta allowing exchange for a sheathless guide catheter (e.g. Asahi SheathLess Eaucath®). This technique can be very helpful for improving lubricity and facilitating coronary intervention where standard guide catheters will not travel and avoid the puncture of a second access site.