title: External side-compression of radial artery: a simple technique for successful advancement of guidewires through the radial approach.
abstract: BACKGROUND
  The transradial approach has several pitfalls that include problems regarding the radial puncture and difficulties with the catheter technique. We evaluated whether external side-compression of radial artery was helpful to yield the success rate for advancement of guidewires under the presence of side branches or arterial tortuosity.
  
  
  RESULTS
  The study population consisted of 11 patients with unsuccessful advancement of guidewires into the brachial artery. In 7 patients, the J-tip hydrophilic guidewire was not advanced into the brachial artery because it always directed into the side branch. During external side-compression of radial artery at the culprit site with a finger of the second operator, the guidewire was successfully advanced into the brachial artery in all patients. In 4 patients, the guidewire was not advanced into the brachial artery because the radial artery was tortuous. During external side-compression of radial artery at the culprit site, the guidewire was successfully advanced into the brachial artery in 2 patients. In the remaining 2 patients in whom this attempt was unsuccessful, coronary angiography was performed through the right brachial artery. Overall success rate of this technique was 82%.
  
  
  CONCLUSIONS
  External side-compression of radial artery is an easy and feasible technique for difficulties in the advancement of guidewires due to the presence of side branches or arterial tortuosity.
authors: Department of Cardiovascular Medicine, Hiroshima University Graduate School of Biomedical Sciences, Hiroshima, Japan. skurisu@hiroshima-u.ac.jp
authors: Satoshi
authors: S
authors: Kurisu
authors: Naoya
authors: N
authors: Mitsuba
authors: Yasuko
authors: Y
authors: Kato
authors: Ken
authors: K
authors: Ishibashi
authors: Yoshihiro
authors: Y
authors: Dohi
authors: Kenji
authors: K
authors: Nishioka
authors: Yasuki
authors: Y
authors: Kihara
mesh_terms: D000368:Aged; D000369:Aged, 80 and over; D001916:Brachial Artery; D017023:Coronary Angiography / Q000295:instrumentation / Q000379:methods*; D003324:Coronary Artery Disease / Q000628:therapy*; D005240:Feasibility Studies; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D017534:Radial Artery