1. Arterial access פרופ ' אריאל רוגין מנהל היחידה לקרדיולוגיה פולשנית מרכז רפואי רמב " ם, חיפה

3. Arterial access

4. 1. Basic principles

5. 2. Selection of puncture site

6. 3. Preparation of puncture materials

7. 4. Patient installation and monitoring

8. 5. Sedation if indicated

9. 6. Palpation of the artery

10. 7. Skin preparation

11. 7. Skin preparation. Radial

14. Arterial Puncture (1)

15. Arterial Puncture (2)

16. Arterial Puncture (3)

17. Common Errors in Punctures

21. What if the wire won’t pass?

23. Advantages

25. Disadvantages

27. Major contra-indications

28. Allen test

30. Relative contra-indication

31. Radial puncture

33. What if the wire won’t pass?

34. From the radial puncture to the ascending aorta

35. Radial approach

36. Radial artery compression

38. Radial or femoral?

39. Why radial or femoral?

40. Vascular complications

41. The cardiac catheterization handbook. 4 th ed.2003. Moron J. Kern Indications for alternative routes to Trans Femoral approach

42. Anatomy of Radial vs Femoral Artery

43. Vascular access Site management (2003 estimate use)

44. Radial approach in western Europe

46. Description of studies included in the Meta-Analysis

47. Results - clinical conditions

48. Safety favors Radial

49. Entry site complications

50. TRA-Meta-analysis discussion

51. Secondary outcomes

52. Conclusions of this Meta-Analysis

53. Radial versus Femoral? Conclusions

55. Complications of femoral puncture

56. Bleeding

57. Hematoma

59. Pseudo-aneurysm

60. Pseudo-aneurysm - treatment

61. Distal Embolisation

62. Site/ Treatment of Embolisation

63. Preventing Puncture Site Thrombosis

64. Complications of radial puncture

65. Summary

67. Methods of Haemostasis

68. 1. Manual compression

69. 1. Manual compression: femoral artery

72. 1. Manual compression: radial artery Sheath removal

73. 1.Manual compression: radial artery Bandage

74. 1.Manual compression: radial artery Patient care

75. 1. Manual compression: brachial artery

76. 2. Mechanical compression Femostop

77. 2. Manual compression: Compression with C-clamp

78. 3. Percutaneous closure devices

79. Angioseal

80. MYNX

81. Exco-seal

82. STARCLOSE