Feasibility of transradial coronary angiography and intervention using a single Ikari left guiding catheter for ST elevation myocardial infarction.

Background: Transradial coronary intervention (TRI) has been widely adopted in ST elevation myocardial infarction (STEMI) patients but there is limited literature on the use of a single catheter for both diagnostic angiography and intervention. We aim to evaluate the feasibility and outcomes of TRI with a single Ikari left (IL) guiding catheter in STEMI patients.

Methods: This is a retrospective study of 362 consecutive STEMI patients from August 2007 to December 2008.

Brachial approach for coronary angiography and intervention: totally obsolete, or a feasible alternative when radial access is not possible?

Introduction: This study aims to assess the safety and feasibility of brachial arterial puncture for coronary procedures when radial access is not possible. Radial arterial approach is the usual option for coronary procedures in our hospital. Whenever radial access is not possible, the brachial approach is preferred instead of the femoral approach.

Bilateral percutaneous ulnar artery approach for retrograde chronic total occlusion intervention.

The transradial approach for coronary diagnostic and therapeutic interventions is a well-established, safe, and effective technique that has shown a success rate comparable to that of the transfemoral approach for chronic total occlusion (CTO) with less access site complications. Recently, the transulnar approach was also found to be a safe and feasible alternative for diagnostic and percutaneous coronary intervention (PCI). There is limited data on the efficacy and safety of the transulnar approach for CTO PCI.

Transradial carotid stenting in a patient with bovine arch anatomy.

Carotid stenting in difficult arch anatomy can be safely done by transradial route depending upon operator's experience. Left carotid artery stenosis with bovine arch anatomy can be approached by right arm approach (radial/brachial) easily. In cases with bovine arch anatomy, left arm approach by modified looping technique is still possible.

Complete stent dislodgement after successful implantation--a rare case.

A successfully deployed stent is normally stable in position and unlikely to be dislodged from the coronary artery. We report a case of complete stent dislodgement after successful implantation in a patient with recent anterior myocardial infarction (AMI). Coronary angulation, a highly calcified coronary artery, an under-deployed stent, and the process of rewiring contributed to this unexpected event.