×
It looks like you're using an obsolete version of internet explorer. Internet explorer is no longer supported by Microsoft since the end of 2015. We invite you to use a newer browser such as Firefox, Google Chrome or Microsoft Edge.
My Player placeholder

Become an Incathlab member and receive full access to its content!

You must be an Incathlab member to access videos without any restrictions. Register for free in one minute and access all services provided by Incathlab.You will also be able to log into Incathlab from your Facebook or twitter account by clicking on login on the top-right corner of Incathlab website.

Registration Login


34542 views
  • TAVI Me G. M-L
  • 93 Y.O
  • Symptomatic AS. NYHA IV
  • severe COPD and Asthma
  • June & Aug 11 : Cardiac failure
  • EUROSCORE = 25,1 %
  • STS = 13,7 %

TOOL BOX Trans Radial Approach
Prepared by B. FAURIE & J. AZZI


1 - Puncture
- Home made plexiglass arm board for wrist hyperextension
- Emla® cream 1H before procedure on both wrists
- Local anesthesia with 1ml of Xylocaine® 1%.
- Venous canula 20 G built in the introducer kit 
- Radial cocktail injected through the sheath: verapamil 3mg, Risordan® (Trinitrine) 2mg
- IV Heparin 70 UI/kg (100UI/kg if PCI)

2 - Introducers
- Cordis RadialSource™ introducer kit available in 6.5 - 10 – 20 cm in 4F, 5F and 6F with a short 20G venous canula and either 0.014" polymer coated guidewire or 0.018" spring guidewire
 
Terumo Radifocus® introducer kit available in 7 and 10 cm in 4F, 5F, 6F with venous canula and plastic 0.021" wire
 
- Merit Medical Prelude® available in 4F, 5F and 6F
 
- Terumo Extralong (25cm) hydrophilic Radifocus® introducer for coronary spasm expertise (Methergin® testing) or extreme radial tortuosity. No spasmolytic cocktail administered
 
- Increase introducer diameter (4 to 5F or 6 or 7F...): Terumo or Cordis femoral introducer on the 0.035" J wire in place or SheathLess guiding catheter
 

3 - Wires for catheters advancement
- Cordis Emerald™ .035” J spring wire 150cm 
 
- Boston Scientific .035” J spring wire 150cm
 
- Cordis .035" Aquatrack™, hydrophilic guidewire if failure of .035” spring wire
 
- Terumo.035” Angled Glidewire Advantage™ (180cm) if failure of .035” spring wire (Terumo Glidewire®: J Tip .035”, 180cm length, Product Code #HR35183M)
 
- .014“Abbott Vascular BMW®, Pilot® 50 in case of extreme radial tortuosity or loops
 
- No need for exchange wires (210 or 260cm) if you use the hydrophilic mandrin technique : strong serum flushing with a 10cc luerlock syringe over the .035’ wire leaning against  the aortic cusp
 
- Amplatz Extra stiff spring wire 150cm if subclavian or inominate tortuosity or calcifications for catheters exchange

4 - Catheters
A- Diagnostic :
 
- Coronary :
- Cordis® 4 & 5F Judkins right and left (JL 3.5; JR 4), if elderlies patients or small sized persons
- Cordis® 5F Barbeau for other patients. 1 cath for LCA, RCA and LV
- Cordis® 5F and 6F RBL 4 / RBL 5, 1 cath for LCA and RCA 
    
Terumo TIGER (4; 4.5; 5) for LV angiogram: 5F Angled pigtail
 
  For Bypass:
            - JR for SVG and LIMA
            - AL1 and Barbeau for SVG 
            - Cordis Modified Mammary cath for selective injection of RIMA and LIMA via Right Radial: IM Barbeau or IM Bartorelli Cozzi        
            - Cordis Multipurpose 5F for GE graft

-Peripheral angiogram:
           - Cordis Multipurpose 125cm for selective injections of mesenteric, renals, iliacs
           - Simmons for carotids and subclavian 
           - Cordis Markerband pigtail 125 cm (NEW!) for pre-TAVI aortic and ilio-femoral measurement
           - Cordis and Cook Medical Pigtail  125 cm  4F and 5 F    

B- Intervention :
-LCA :
- Cordis® Vista Brite Tip® 5 or 6F XB 3, 3.5, 4 – JFL  ST and LT
- Terumo Heartrail® II BL 3.5, 4 
- Medtronic Launcher® 5 or 6 F  EBU 3,  3.5 , 4
- Asahi Intecc SheathLess 6.5, 7.5 or 8.5F. PB4

-RCA:
- Cordis® Vista Brite Tip® 5 or 6F Barbeau – JFR or AL1 if more backup needed 
Terumo Heartrail® II 5 and 6 F Ikari Right   or AL1 
- Asahi Intecc SheathLess 6.5, 7.5 or 8.5F.  AL1 or 2
- Medtronic Launcher®  AR1, AR2, ALR1,2, AL1 and  AL2

- Peripheral :
a: Renal, Mesenteric : 
- Cordis® Vista Brite Tip® 6F LBT MP 125cm or Barbeau 125cm  
- Asahi Intecc SheathLess MP 100cm (small persons)

b: Iliac: Cordis® Vista Brite Tip® 6F LBT MP 125cm

c: Carotid: Cook shuttle® or Asahi Intecc SheathLess 7.5 or 8.5F MP 100cm

5 - Specific devices
Active intubation and mother and child systems
Terumo Heartrail® II 5 in 6 - 120cm 
- Vascular solutions Guideliner®  5-in-6, 6-in-7, 7-in-8
- Abbott Vascular Wiggle® .014” wire by for increasing deliverability of stents in tortuosity and calcifications

6 - Closing devices
- Home made rolled pile of gauze with elastic adhesive tape. Good for very thin wrist
Terumo TR Band™ Product Code: XX*RF06 (Regular; 24cm) 
Access Closure Bengal™ Radial compression band
Merit Medical Finale™ compression device 
Saint-Jude Radistop™ compression assist device
 
Cordis

 

Shooting date : 2011-09-02
Last update : 2021-06-09

Suggestions

Tuesday, April 23rd 2024 from 05pm to 06:15pm (GMT+2)
Honolulu : Tuesday, April 23rd 2024 from 06am to 07:15am (GMT+2)
San Francisco : Tuesday, April 23rd 2024 from 09am to 10:15am (GMT+2)
New York : Tuesday, April 23rd 2024 from 12pm to 01:15pm (GMT+2)
Buenos Aires : Tuesday, April 23rd 2024 from 01pm to 02:15pm (GMT+2)
Reykjavik : Tuesday, April 23rd 2024 from 04pm to 05:15pm (GMT+2)
London / Dublin : Tuesday, April 23rd 2024 from 05pm to 06:15pm (GMT+2)
Paris / Berlin : Tuesday, April 23rd 2024 from 06pm to 07:15pm (GMT+2)
Istanbul : Tuesday, April 23rd 2024 from 07pm to 08:15pm (GMT+2)
Moscou / Dubaï : Tuesday, April 23rd 2024 from 08pm to 09:15pm (GMT+2)
Bangkok : Tuesday, April 23rd 2024 from 11pm to 12:15am (GMT+2)
Shanghai : Wednesday, April 24th 2024 from 12am to 01:15am (GMT+2)
Tokyo : Wednesday, April 24th 2024 from 01am to 02:15am (GMT+2)
Sydney : Wednesday, April 24th 2024 from 03am to 04:15am (GMT+2)
Wellington : Wednesday, April 24th 2024 from 05am to 06:15am (GMT+2)

From Access to Closure through Treatment:

How to Maximize Outcomes while Minimizing Impact

Share
Wednesday, May 22nd 2024 from 03pm to 04pm (GMT+2)
Honolulu : Wednesday, May 22nd 2024 from 04am to 05am (GMT+2)
San Francisco : Wednesday, May 22nd 2024 from 07am to 08am (GMT+2)
New York : Wednesday, May 22nd 2024 from 10am to 11am (GMT+2)
Buenos Aires : Wednesday, May 22nd 2024 from 11am to 12pm (GMT+2)
Reykjavik : Wednesday, May 22nd 2024 from 02pm to 03pm (GMT+2)
London / Dublin : Wednesday, May 22nd 2024 from 03pm to 04pm (GMT+2)
Paris / Berlin : Wednesday, May 22nd 2024 from 04pm to 05pm (GMT+2)
Istanbul : Wednesday, May 22nd 2024 from 05pm to 06pm (GMT+2)
Moscou / Dubaï : Wednesday, May 22nd 2024 from 06pm to 07pm (GMT+2)
Bangkok : Wednesday, May 22nd 2024 from 09pm to 10pm (GMT+2)
Shanghai : Wednesday, May 22nd 2024 from 10pm to 11pm (GMT+2)
Tokyo : Wednesday, May 22nd 2024 from 11pm to 12am (GMT+2)
Sydney : Thursday, May 23rd 2024 from 01am to 02am (GMT+2)
Wellington : Thursday, May 23rd 2024 from 03am to 04am (GMT+2)

DanGER shock trial results and the significance to reduce adverse events

Share
Wednesday, September 18th 2024 from 12pm to 01pm (GMT+2)
Honolulu : Wednesday, September 18th 2024 from 01am to 02am (GMT+2)
San Francisco : Wednesday, September 18th 2024 from 04am to 05am (GMT+2)
New York : Wednesday, September 18th 2024 from 07am to 08am (GMT+2)
Buenos Aires : Wednesday, September 18th 2024 from 08am to 09am (GMT+2)
Reykjavik : Wednesday, September 18th 2024 from 11am to 12pm (GMT+2)
London / Dublin : Wednesday, September 18th 2024 from 12pm to 01pm (GMT+2)
Paris / Berlin : Wednesday, September 18th 2024 from 01pm to 02pm (GMT+2)
Istanbul : Wednesday, September 18th 2024 from 02pm to 03pm (GMT+2)
Moscou / Dubaï : Wednesday, September 18th 2024 from 03pm to 04pm (GMT+2)
Bangkok : Wednesday, September 18th 2024 from 06pm to 07pm (GMT+2)
Shanghai : Wednesday, September 18th 2024 from 07pm to 08pm (GMT+2)
Tokyo : Wednesday, September 18th 2024 from 08pm to 09pm (GMT+2)
Sydney : Wednesday, September 18th 2024 from 10pm to 11pm (GMT+2)
Wellington : Thursday, September 19th 2024 from 12am to 01am (GMT+2)

Can PCI outcomes get any better?

Advancing the standard of care with bioadaptor

Share
Monday, July 4th 2022 from 05pm to 06pm (GMT+2)
Honolulu : Monday, July 4th 2022 from 06am to 07am (GMT+2)
San Francisco : Monday, July 4th 2022 from 09am to 10am (GMT+2)
New York : Monday, July 4th 2022 from 12pm to 01pm (GMT+2)
Buenos Aires : Monday, July 4th 2022 from 01pm to 02pm (GMT+2)
Reykjavik : Monday, July 4th 2022 from 04pm to 05pm (GMT+2)
London / Dublin : Monday, July 4th 2022 from 05pm to 06pm (GMT+2)
Paris / Berlin : Monday, July 4th 2022 from 06pm to 07pm (GMT+2)
Istanbul : Monday, July 4th 2022 from 07pm to 08pm (GMT+2)
Moscou / Dubaï : Monday, July 4th 2022 from 08pm to 09pm (GMT+2)
Bangkok : Monday, July 4th 2022 from 11pm to 12am (GMT+2)
Shanghai : Tuesday, July 5th 2022 from 12am to 01am (GMT+2)
Tokyo : Tuesday, July 5th 2022 from 01am to 02am (GMT+2)
Sydney : Tuesday, July 5th 2022 from 03am to 04am (GMT+2)
Wellington : Tuesday, July 5th 2022 from 05am to 06am (GMT+2)

Comment optimiser le traitement des longues lésions calcifiées grâce à l’OCT ?

Live-in-a-box case, Angioplastie Coronaire guidée par l’OCT

Share
Thursday, August 25th 2022 from 06pm to 07:06pm (GMT+2)
Honolulu : Thursday, August 25th 2022 from 07am to 08:06am (GMT+2)
San Francisco : Thursday, August 25th 2022 from 10am to 11:06am (GMT+2)
New York : Thursday, August 25th 2022 from 01pm to 02:06pm (GMT+2)
Buenos Aires : Thursday, August 25th 2022 from 02pm to 03:06pm (GMT+2)
Reykjavik : Thursday, August 25th 2022 from 05pm to 06:06pm (GMT+2)
London / Dublin : Thursday, August 25th 2022 from 06pm to 07:06pm (GMT+2)
Paris / Berlin : Thursday, August 25th 2022 from 07pm to 08:06pm (GMT+2)
Istanbul : Thursday, August 25th 2022 from 08pm to 09:06pm (GMT+2)
Moscou / Dubaï : Thursday, August 25th 2022 from 09pm to 10:06pm (GMT+2)
Bangkok : Friday, August 26th 2022 from 12am to 01:06am (GMT+2)
Shanghai : Friday, August 26th 2022 from 01am to 02:06am (GMT+2)
Tokyo : Friday, August 26th 2022 from 02am to 03:06am (GMT+2)
Sydney : Friday, August 26th 2022 from 04am to 05:06am (GMT+2)
Wellington : Friday, August 26th 2022 from 06am to 07:06am (GMT+2)

SmartAssist and Connect Function – Improved Patient Outcome

Impella Case Club

Share
Thursday, March 16th 2023 from 05pm to 07:30pm (GMT+1)
Honolulu : Thursday, March 16th 2023 from 06am to 08:30am (GMT+1)
San Francisco : Thursday, March 16th 2023 from 08am to 10:30am (GMT+1)
New York : Thursday, March 16th 2023 from 11am to 01:30pm (GMT+1)
Buenos Aires : Thursday, March 16th 2023 from 01pm to 03:30pm (GMT+1)
London / Dublin : Thursday, March 16th 2023 from 04pm to 06:30pm (GMT+1)
Paris / Berlin : Thursday, March 16th 2023 from 05pm to 07:30pm (GMT+1)
Istanbul : Thursday, March 16th 2023 from 06pm to 08:30pm (GMT+1)
Moscou / Dubaï : Thursday, March 16th 2023 from 08pm to 10:30pm (GMT+1)
Bangkok : Thursday, March 16th 2023 from 11pm to 01:30am (GMT+1)
Shanghai : Friday, March 17th 2023 from 12am to 02:30am (GMT+1)
Tokyo : Friday, March 17th 2023 from 01am to 03:30am (GMT+1)
Sydney : Friday, March 17th 2023 from 02am to 04:30am (GMT+1)
Wellington : Friday, March 17th 2023 from 04am to 06:30am (GMT+1)

Bifurcation PCI - Insights from the Visible Heart® Lab 

Share
Wednesday, April 26th 2023 from 01pm to 02:30pm (GMT+2)
Honolulu : Wednesday, April 26th 2023 from 02am to 03:30am (GMT+2)
San Francisco : Wednesday, April 26th 2023 from 05am to 06:30am (GMT+2)
New York : Wednesday, April 26th 2023 from 08am to 09:30am (GMT+2)
Buenos Aires : Wednesday, April 26th 2023 from 09am to 10:30am (GMT+2)
Reykjavik : Wednesday, April 26th 2023 from 12pm to 01:30pm (GMT+2)
London / Dublin : Wednesday, April 26th 2023 from 01pm to 02:30pm (GMT+2)
Paris / Berlin : Wednesday, April 26th 2023 from 02pm to 03:30pm (GMT+2)
Istanbul : Wednesday, April 26th 2023 from 03pm to 04:30pm (GMT+2)
Moscou / Dubaï : Wednesday, April 26th 2023 from 04pm to 05:30pm (GMT+2)
Bangkok : Wednesday, April 26th 2023 from 07pm to 08:30pm (GMT+2)
Shanghai : Wednesday, April 26th 2023 from 08pm to 09:30pm (GMT+2)
Tokyo : Wednesday, April 26th 2023 from 09pm to 10:30pm (GMT+2)
Sydney : Wednesday, April 26th 2023 from 11pm to 12:30am (GMT+2)
Wellington : Thursday, April 27th 2023 from 01am to 02:30am (GMT+2)

CAMP LIVE CASE

European Session from Luzerner Kantonsspital

Share
Saturday, November 11th 2023 from 02:30am to 05am (GMT+1)
Honolulu : Friday, November 10th 2023 from 03:30pm to 06pm (GMT+1)
San Francisco : Friday, November 10th 2023 from 05:30pm to 08pm (GMT+1)
New York : Friday, November 10th 2023 from 08:30pm to 11pm (GMT+1)
Buenos Aires : Friday, November 10th 2023 from 10:30pm to 01am (GMT+1)
London / Dublin : Saturday, November 11th 2023 from 01:30am to 04am (GMT+1)
Paris / Berlin : Saturday, November 11th 2023 from 02:30am to 05am (GMT+1)
Istanbul : Saturday, November 11th 2023 from 03:30am to 06am (GMT+1)
Moscou / Dubaï : Saturday, November 11th 2023 from 05:30am to 08am (GMT+1)
Bangkok : Saturday, November 11th 2023 from 08:30am to 11am (GMT+1)
Shanghai : Saturday, November 11th 2023 from 09:30am to 12pm (GMT+1)
Tokyo : Saturday, November 11th 2023 from 10:30am to 01pm (GMT+1)
Sydney : Saturday, November 11th 2023 from 11:30am to 02pm (GMT+1)
Wellington : Saturday, November 11th 2023 from 01:30pm to 04pm (GMT+1)

Bifurcation PCI

Insights from the Visible Heart® Lab

Share
Scroll Up