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Objective: Transradial cardiac catheterization has gained popularity because of its reduced risk of access-site complications, yet procedural failures remain frequent, often caused by subclavian artery tortuosity. We propose an alternative maneuver to improve procedural success rates, addressing the challenge of subclavian artery tortuosity more efficiently than existing time-consuming and resource-intensive techniques.
Key Steps: Place a towel between the patient's scapulae to retract the shoulders before advancing the catheter.
Potential Pitfalls: Aside from the increased time taken to place the towel and patient discomfort, no pitfalls are anticipated when attempting this maneuver.
Take-home Messages: In cases of severe subclavian artery tortuosity, positioning the patient supine with a towel between the scapulae can facilitate successful transradial cardiac catheterization.
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http://dx.doi.org/10.1016/j.jaccas.2024.103225 | DOI Listing |
J Magn Reson Imaging
September 2025
Department of Diagnostic Imaging and Nuclear Medicine, Kyoto University Graduate School of Medicine, Kyoto, Japan.
Background: Carotid artery stenosis is a major cause of stroke. Non-contrast MR angiography (MRA) using time-spatial labeling inversion pulse (Time-SLIP) may offer potential advantages over 3D time-of-flight (TOF)-MRA for simultaneous visualization of carotid, vertebral, and subclavian arteries, but remains uninvestigated.
Purpose: To determine optimal black blood inversion time (TI) for visualizing the carotid and subclavian arteries using three-dimensional (3D) fast field echo (FFE) Time-SLIP MRA, and to compare its image quality with 3D TOF-MRA.
J Magn Reson Imaging
September 2025
Department of Radiology, University of California, San Diego, La Jolla, California, USA.
Interv Neuroradiol
September 2025
Department of Neuroradiology, University Hospital RWTH Aachen, Aachen, Germany.
PurposeTo evaluate the potential of Photon-Counting Detector CT Angiography (PCD-CTA) for the assessment of carotid and subclavian artery stents compared to digital subtraction angiography (DSA) and Duplex ultrasound (DUS).MethodsThis study is a single-center, retrospective analysis of consecutive patients treated with a stent for high grade stenosis of the extra-cranial carotid and the subclavian artery between April 2023 and May 2024. Polyenergetic images (PE), iodine and virtual monoenergetic images were performed at different keV levels (40 and 80) and with two body vascular reconstruction kernels (Bv56 and 72) with and without iterative metal artifact reduction.
View Article and Find Full Text PDFSci Prog
September 2025
Faculty of Medicine, Universitas Indonesia, Jakarta, Indonesia.
Single coronary ostium and intramural coronary artery variations in patients with transposition of the great arteries significantly increase the mortality and morbidity after arterial switch operation (ASO). In these patients, the classic coronary button implantation may cause kinking or twisting of the coronary artery which can cause coronary insufficiency. This case series presents two patients, a 15-month-old girl with transposition of the great arteries and a 10-month-old boy with a Taussig-Bing anomaly.
View Article and Find Full Text PDFJ Neuroendovasc Ther
August 2025
Department of Neurosurgery, Graduate School of Biomedical and Health Sciences, Hiroshima University, Hiroshima, Hiroshima, Japan.
Objective: Endovascular treatment of cerebrovascular diseases can be challenging in patients with difficult access routes. We describe a turn-over technique using a balloon guiding catheter (BGC) via the transfemoral approach to perform neuroendovascular treatment.
Case Presentation: An 80-year-old female with a recurrent right middle cerebral artery (MCA) aneurysm after coil embolization underwent successful stent-assisted coiling via the transfemoral approach.