Complex Right Subclavian Artery Stenting via Radial Artery Approach

Hady L.

I am impressed that you can place a long 6 F sheath in the radial artery which has an outer diamter equivalent to an 8F guiding catheter, without having radial artery spasm or post-procedure occlusion (despite adequate sedation, vasodilators and anticoagulation). The short 6 F Terumo sheaths that we use for coronary interventions don't have this risk because they are very short.

I did not see that you did a radial angiogram before you introduced the long sheath. From your experience, have you had severe radial vasoconstriction specifically in women depsite adequate vasodilation and anticoagulation? What do you recommend if there is a lot of resistance while pulling the long sheath out?

Because of this frequent problem in women I have switched to a brachial approach to treat similar proximal subclavian arteries. 

Thank you.

Hady Lichaa, MD

The Greenville clinic 

Greenville, Mississippi, USA