title: Transradial Approach of Alcohol Septal Ablation Using a Sheathless Guiding Catheter: A Feasibility Study.
abstract: OBJECTIVE
  We aimed to investigate the feasibility and safety of alcohol septal ablation (ASA) via transradial approach using a sheathless guiding catheter.
  
  
  BACKGROUND
  Although ASA is conventionally performed via the femoral artery, there is a potential risk of bleeding and other vascular complications. The transradial approach may be associated with a lower rate of such complications. A sheathless guiding catheter, with an advanced hydrophilic coating along its full length, could reduce radial artery occlusion and spasm.
  
  
  METHODS
  We enrolled 14 consecutive patients with hypertrophic obstructive cardiomyopathy treated with ASA via the radial access at Sendai Kousei Hospital from December 2012 to May 2014. Left radial access was used for the sheathless guiding catheter, while right radial access was used for monitoring left ventricular pressure with a 4 Fr diagnostic catheter. A temporary pacemaker was inserted via the right jugular vein.
  
  
  RESULTS
  Procedural success rate was 93% (13/14 patients). The left ventricular outflow tract pressure gradient at rest was reduced from a median of 128 mm Hg (interquartile range, 49-147 mm Hg) at baseline to a median of 16 mm Hg (interquartile range, 13-26 mm Hg) at 30-day follow-up (P=.01). The New York Heart Association functional class improved from a median of II (II-III) at baseline to a median of I (I-I) at 30-day follow-up (P=.01). There were no cases of access-site complication, including radial artery occlusion and spasm.
  
  
  CONCLUSIONS
  The transradial approach using a sheathless guiding catheter was feasible and safe for ASA.
authors.affiliation: Department of Cardiology, Sendai Kousei Hospital, 4-15, Hirose-machi, Sendai, 980-0873, Japan. isa_tsuyo@yahoo.co.jp.
authors.forename: Tsuyoshi
authors.initials: T
authors.lastname: Isawa
authors.forename: Norio
authors.initials: N
authors.lastname: Tada
authors.forename: Tatsushi
authors.initials: T
authors.lastname: Ootomo
authors.forename: Mie
authors.initials: M
authors.lastname: Sakurai
authors.forename: Kaname
authors.initials: K
authors.lastname: Takizawa
authors.forename: Naoto
authors.initials: N
authors.lastname: Inoue
mesh_terms: D055011:Ablation Techniques / Q000295:instrumentation*; D000368:Aged; D006328:Cardiac Catheterization / Q000295:instrumentation*; D062906:Cardiac Catheters; D002312:Cardiomyopathy, Hypertrophic / Q000601:surgery*; D004867:Equipment Design; D000431:Ethanol / Q000494:pharmacology*; D005240:Feasibility Studies; D005260:Female; D006346:Heart Septum / Q000601:surgery*; D006801:Humans; D008297:Male; D008875:Middle Aged; D017534:Radial Artery; D016896:Treatment Outcome
chemical_list: D000431:Ethanol