{"title":"在锁骨下动脉迂曲的情况下,使用头部左转手法将导线推进升主动脉,从而挽救右桡动脉心导管术","authors":"Mohammad Reza Movahed","doi":"10.1016/j.crmic.2024.100045","DOIUrl":null,"url":null,"abstract":"<div><div>Cardiac catheterization via the right radial artery is associated with a lower complication rate and is gaining popularity. However, there are unique challenges that can lead to procedural failure. One of the major challenges is advancing guide wire into the ascending aorta in a very tortuous subclavian artery. The deep inspiratory maneuver is one of the important maneuvers to overcome wire advancement into the aorta. However, in some cases, the wire will enter the descending aorta with great difficulty in repositioning in the ascending aorta. In this case, we describe a case of a very tortuous subclavian artery that prevents wire advancement into the ascending aorta despite repositioning the catheter and performing deep inspiratory maneuvers. However, after instructing the patient to move her head to the left, wire advancement into the ascending aorta was easily achieved. In this case report, an easy-to-perform maneuver is described in these tough situations that can save the procedure that was started via the right radial route.</div></div>","PeriodicalId":100217,"journal":{"name":"Cardiovascular Revascularization Medicine: Interesting Cases","volume":null,"pages":null},"PeriodicalIF":0.0000,"publicationDate":"2024-09-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.sciencedirect.com/science/article/pii/S2950275624000418/pdfft?md5=5ab79eacbf7e1400356819d826cf89d7&pid=1-s2.0-S2950275624000418-main.pdf","citationCount":"0","resultStr":"{\"title\":\"Saving right radial cardiac catheterization with tortuous subclavian artery using head left turning maneuver for facilitating wire advancement into the ascending aorta\",\"authors\":\"Mohammad Reza Movahed\",\"doi\":\"10.1016/j.crmic.2024.100045\",\"DOIUrl\":null,\"url\":null,\"abstract\":\"<div><div>Cardiac catheterization via the right radial artery is associated with a lower complication rate and is gaining popularity. However, there are unique challenges that can lead to procedural failure. One of the major challenges is advancing guide wire into the ascending aorta in a very tortuous subclavian artery. The deep inspiratory maneuver is one of the important maneuvers to overcome wire advancement into the aorta. However, in some cases, the wire will enter the descending aorta with great difficulty in repositioning in the ascending aorta. In this case, we describe a case of a very tortuous subclavian artery that prevents wire advancement into the ascending aorta despite repositioning the catheter and performing deep inspiratory maneuvers. However, after instructing the patient to move her head to the left, wire advancement into the ascending aorta was easily achieved. In this case report, an easy-to-perform maneuver is described in these tough situations that can save the procedure that was started via the right radial route.</div></div>\",\"PeriodicalId\":100217,\"journal\":{\"name\":\"Cardiovascular Revascularization Medicine: Interesting Cases\",\"volume\":null,\"pages\":null},\"PeriodicalIF\":0.0000,\"publicationDate\":\"2024-09-17\",\"publicationTypes\":\"Journal Article\",\"fieldsOfStudy\":null,\"isOpenAccess\":false,\"openAccessPdf\":\"https://www.sciencedirect.com/science/article/pii/S2950275624000418/pdfft?md5=5ab79eacbf7e1400356819d826cf89d7&pid=1-s2.0-S2950275624000418-main.pdf\",\"citationCount\":\"0\",\"resultStr\":null,\"platform\":\"Semanticscholar\",\"paperid\":null,\"PeriodicalName\":\"Cardiovascular Revascularization Medicine: Interesting Cases\",\"FirstCategoryId\":\"1085\",\"ListUrlMain\":\"https://www.sciencedirect.com/science/article/pii/S2950275624000418\",\"RegionNum\":0,\"RegionCategory\":null,\"ArticlePicture\":[],\"TitleCN\":null,\"AbstractTextCN\":null,\"PMCID\":null,\"EPubDate\":\"\",\"PubModel\":\"\",\"JCR\":\"\",\"JCRName\":\"\",\"Score\":null,\"Total\":0}","platform":"Semanticscholar","paperid":null,"PeriodicalName":"Cardiovascular Revascularization Medicine: Interesting Cases","FirstCategoryId":"1085","ListUrlMain":"https://www.sciencedirect.com/science/article/pii/S2950275624000418","RegionNum":0,"RegionCategory":null,"ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":null,"EPubDate":"","PubModel":"","JCR":"","JCRName":"","Score":null,"Total":0}
Saving right radial cardiac catheterization with tortuous subclavian artery using head left turning maneuver for facilitating wire advancement into the ascending aorta
Cardiac catheterization via the right radial artery is associated with a lower complication rate and is gaining popularity. However, there are unique challenges that can lead to procedural failure. One of the major challenges is advancing guide wire into the ascending aorta in a very tortuous subclavian artery. The deep inspiratory maneuver is one of the important maneuvers to overcome wire advancement into the aorta. However, in some cases, the wire will enter the descending aorta with great difficulty in repositioning in the ascending aorta. In this case, we describe a case of a very tortuous subclavian artery that prevents wire advancement into the ascending aorta despite repositioning the catheter and performing deep inspiratory maneuvers. However, after instructing the patient to move her head to the left, wire advancement into the ascending aorta was easily achieved. In this case report, an easy-to-perform maneuver is described in these tough situations that can save the procedure that was started via the right radial route.