Michael Koutouzis, MD, PhD, FESC Interventional ... · Material miniaturization during transradial...

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Material miniaturization during transradial approach Michael Koutouzis, MD, PhD, FESC Interventional Cardiologist, 2nd Department of Cardiology Hellenic Red Cross General Hospital

Transcript of Michael Koutouzis, MD, PhD, FESC Interventional ... · Material miniaturization during transradial...

Page 1: Michael Koutouzis, MD, PhD, FESC Interventional ... · Material miniaturization during transradial approach Michael Koutouzis, MD, PhD, FESC Interventional Cardiologist, 2nd Department

Material miniaturization during transradial approach

Michael Koutouzis, MD, PhD, FESC

Interventional Cardiologist,

2nd Department of Cardiology

Hellenic Red Cross General Hospital

Page 2: Michael Koutouzis, MD, PhD, FESC Interventional ... · Material miniaturization during transradial approach Michael Koutouzis, MD, PhD, FESC Interventional Cardiologist, 2nd Department

Conflict of interest

- Astra Zeneca Hellas

- Lilly-Φαρμασερβ

- Galenica A.E.

- ELPEN A.E.

Page 3: Michael Koutouzis, MD, PhD, FESC Interventional ... · Material miniaturization during transradial approach Michael Koutouzis, MD, PhD, FESC Interventional Cardiologist, 2nd Department

Why should we reduce material size?

- Improve patient comfort

- Reduce the incidence of RAO

Page 4: Michael Koutouzis, MD, PhD, FESC Interventional ... · Material miniaturization during transradial approach Michael Koutouzis, MD, PhD, FESC Interventional Cardiologist, 2nd Department

Radial Artery Inner Diameter/Sheath Outer Diameter (RAID/SOD)

RAID/SOD ≥1 4%

RAID/SOD <1 13%

Page 5: Michael Koutouzis, MD, PhD, FESC Interventional ... · Material miniaturization during transradial approach Michael Koutouzis, MD, PhD, FESC Interventional Cardiologist, 2nd Department
Page 6: Michael Koutouzis, MD, PhD, FESC Interventional ... · Material miniaturization during transradial approach Michael Koutouzis, MD, PhD, FESC Interventional Cardiologist, 2nd Department

SHEATH OUTER DIAMETERS

4F 2mm

5F 2.3mm

6F 2.7mm

7F 2.85mm

8F 3.22mm

Page 7: Michael Koutouzis, MD, PhD, FESC Interventional ... · Material miniaturization during transradial approach Michael Koutouzis, MD, PhD, FESC Interventional Cardiologist, 2nd Department

Reduce size by 1Fr

Page 8: Michael Koutouzis, MD, PhD, FESC Interventional ... · Material miniaturization during transradial approach Michael Koutouzis, MD, PhD, FESC Interventional Cardiologist, 2nd Department

Sheathless Catheters

Reduce size 1-2 Fr

Page 9: Michael Koutouzis, MD, PhD, FESC Interventional ... · Material miniaturization during transradial approach Michael Koutouzis, MD, PhD, FESC Interventional Cardiologist, 2nd Department

Reduce size 1-2 Fr

Page 10: Michael Koutouzis, MD, PhD, FESC Interventional ... · Material miniaturization during transradial approach Michael Koutouzis, MD, PhD, FESC Interventional Cardiologist, 2nd Department

Sheathless Catheter preperation and insertion

Page 11: Michael Koutouzis, MD, PhD, FESC Interventional ... · Material miniaturization during transradial approach Michael Koutouzis, MD, PhD, FESC Interventional Cardiologist, 2nd Department

Sheathless Catheter preperation and insertion

Page 12: Michael Koutouzis, MD, PhD, FESC Interventional ... · Material miniaturization during transradial approach Michael Koutouzis, MD, PhD, FESC Interventional Cardiologist, 2nd Department

B

Insertion achieved using 5Fr x 125cm Shuttle Select diagnostic catheter

Page 13: Michael Koutouzis, MD, PhD, FESC Interventional ... · Material miniaturization during transradial approach Michael Koutouzis, MD, PhD, FESC Interventional Cardiologist, 2nd Department

125cm 5Fr multipurpose diagnostic catheter

5 in 6Fr Guideliner Catheter

Dilator of a 4Fr 110cm sheath into 5Fr catheter

Partially inflated coronary balloon

Page 14: Michael Koutouzis, MD, PhD, FESC Interventional ... · Material miniaturization during transradial approach Michael Koutouzis, MD, PhD, FESC Interventional Cardiologist, 2nd Department

High complication rate

13% Radial Artery occlusion11% early pseudoaneurysmal dilatation20% localized hematoma

Page 15: Michael Koutouzis, MD, PhD, FESC Interventional ... · Material miniaturization during transradial approach Michael Koutouzis, MD, PhD, FESC Interventional Cardiologist, 2nd Department
Page 16: Michael Koutouzis, MD, PhD, FESC Interventional ... · Material miniaturization during transradial approach Michael Koutouzis, MD, PhD, FESC Interventional Cardiologist, 2nd Department
Page 17: Michael Koutouzis, MD, PhD, FESC Interventional ... · Material miniaturization during transradial approach Michael Koutouzis, MD, PhD, FESC Interventional Cardiologist, 2nd Department

Thank you


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