Transradial Approach for Left Ventricular Endomyocardial Biopsy

Tawfiq Choudhury, Tim G. Schäufele, Shahar Lavi, Katsutoshi Makino, Miguel Nobre Menezes, Amir Solomonica, Olivier F. Bertrand, Ian Gilchrist, Mamas A. Mamas, Rodrigo Bagur

Research output: Contribution to journalArticle

3 Scopus citations

Abstract

Background: Left ventricular endomyocardial biopsy (LV-EMB) may offer a superior diagnostic yield compared with right ventricular endomyocardial biopsy (RV-EMB) in conditions predominantly affecting the LV but is underused compared with RV-EMB. Despite the steep uptake of radial approach in coronary interventions, LV-EMB is usually performed via the femoral artery in contemporary practice. Therefore, the aim of this study was to assess the safety and feasibility of LV-EMB via a transradial approach in a multicentre registry. Methods: One-hundred and two patients who underwent LV-EMB via transradial approach were included. Clinical characteristics, procedural, safety and feasibility data were evaluated. Results: LV-EMB was successfully performed via transradial access in 101 (99%) patients. Mild or moderate radial artery spasm occurred in 12 (12%) patients, but only 1 (0.98%) patient required conversion to femoral access due to severe spasm. A total of 80 (78%) patients had LV-EMB via a sheathless guide catheter. Among those, 77 (96.3%) patients had 7.5-French sheathless guides, and 3 (3.8%) patients had 8.5-French sheathless guides inserted. Radial sheaths were used in the remaining 22 patients, with 5-French sheaths in 21 of 22 patients. Heparin was administered to 93.1% of patients at a median dose of 5000 (3000–5000) IU. The remaining patients followed a provisional strategy upon patent hemostasis achievement. No access site-related complications were reported. There were no major complications (pericardial tamponade, life-threatening arrhythmia, cerebrovascular accident or death). Conclusions: In a population of patients undergoing transradial LV-EMB, the procedural success rate was high and showed an excellent safety profile. Further studies comparing transradial and transfemoral routes may help expand the use of transradial access for LV-EMB.

Original languageEnglish (US)
Pages (from-to)1283-1288
Number of pages6
JournalCanadian Journal of Cardiology
Volume34
Issue number10
DOIs
StatePublished - Oct 2018

All Science Journal Classification (ASJC) codes

  • Cardiology and Cardiovascular Medicine

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    Choudhury, T., Schäufele, T. G., Lavi, S., Makino, K., Nobre Menezes, M., Solomonica, A., Bertrand, O. F., Gilchrist, I., Mamas, M. A., & Bagur, R. (2018). Transradial Approach for Left Ventricular Endomyocardial Biopsy. Canadian Journal of Cardiology, 34(10), 1283-1288. https://doi.org/10.1016/j.cjca.2018.05.007