1. Transradial interventions -local perspective
Dr Syed Nadeem Hassan Rizvi,
MBBS (Pb), Dip Card (lon) , MRCP(UK), FSCAI
As. Professor of Cardiology,
National institute of Cardiovascular diseases,
Karachi

2. Early (immediate?) ambulation
Why Transradial ?
Early (immediate?) ambulation
Less local complications than transfemoral
Less ‘labour / staff ’ intensive

3. Downside of transradial
Steep learning curve
Limited availability of specific radial catheters at present
Access limited upto 7F in most patients , which therefore, excludes certain techniques e.g simultaneous stenting and IABP insertion

4. TRI-Preparation

5. TRI-Preparation

6. TRI-Preparation

7. TRI-Preparation

8. TRI-Final table setup

9. TRI- Local anaesthetic

10. TRI- Access

11. TRI- Access

12. TRI- Access

13. TRI - Access

14. TRI- Sheath removal

15. TRI- Access closure / TR band

16. TRI- Access closure / TR band

17. TRI – TR band closure

18. TRI- Immediate ambulation

19. TRI- Material Easy Radial Radistop Gauze and tape/ bandage Stepty P
Radstat

20. TRI- Diagnostic catheters

21. TRI- Guiding catheters

22. Guide catheters Fadajet (Cordis) Muta wiseguide (BSS)
Kimney Runway (BSS)
Mann IMA (BSS)
Radial curve (BSS)

23. Radial / brachial anatomy

24. JR for LCA

25. TRI- Primary PCI

26. TRI- Primary PCI

27. TRI- Primary PCI

28. TRI – Kissing balloon (6F access)

29. TRI- bifurcation PCI

30. TRI – bifurcation PCI

31. TRI – Complex rescue PCI

32. TRI – Complex rescue PCI

34. Conclusion I TRI is a safe and effective procedure
Has a steep learning curve and therefore needs persistence and dedication to master technique
Variety of specific hardware is limited in Pakistan mainly due to low volumes

35. Conclusion II
Fluro times are marginally longer than femoral procedures but usually decline with increasing expertise
No specific subgroup should be exempted from this technique except those where >7F diameter access is necessary
Teaching institutes should try and adopt this technique as ‘first line’ due to its safety and cost effectiveness

36. Thank You