Читать книгу Interventional Cardiology - Группа авторов - Страница 79

Arterial loops are a common cause of ipsilateral transradial failure even for experienced radial operators – mainly because very small diameter loops may not straighten after wire passage and can cause pain with increased procedural duration. Typically, loops involve a section of radial artery that travels back proximally towards the brachial bifurcation before heading down to the forearm. Navigating the loop is made more challenging by the invariable association with a recurrent (accessory) radial artery (Figure 3.1c), which typically is a small caliber vessel with a straight path up the arm from the apex of the loop. After arm angiography, small loops can usually be navigated with a coronary wire or a steerable hydrophilic wire into the brachial artery. Wire passage alone may straighten the loop, or small calibre (i.e. 4Fr or 5Fr) may be exchanged allowing passage of a 0.035" wire with gentle traction allowing the loop to be straightened permitting the case to be completed in over two thirds of cases [27].