Читать книгу Interventional Cardiology - Группа авторов - Страница 86

Perforation is reported in less than 1% of transradial artery catheterization (Figure 3.3a)[44]. The risk can be mitigated further through using J‐shaped wires. Unintentional wire or catheter advancement into small side branches can lead to perforation. Resistance is often felt; however, if not, the onset of arm pain or vasovagal symptoms should prompt the interventionalist to pause and perform radial artery angiography to delineate the anatomy and determine appropriate management strategy. Tortuous and small caliber vessels are risk factors for perforation [45]. Careful use of a 0.014″ coronary guidewire beyond the perforated segment allows the catheter to cross the perforation thereby acting as a sealant. If the segment cannot be crossed, immediate compression should be performed to prevent hematoma formation.