Transradial approach for subclavian intervention - Olivier Bertrand

1. RADIAL APPROACH FOR
SUBCLAVIAN INTERVENTION
Olivier F. Bertrand, MD, PhD
Associate-Professor of Medicine, Laval University
Adjunct-Professor, Department of Mechanical Engineering, McGill University
International Chair on Interventional Cardiology and Transradial Approach
Quebec Heart-Lung Institute
Slender Club Japan- 15 April 2017

2. • I have no conflict of interest to declare
DISCLOSURE

3. LEFT SUBCLAVIAN ANGIOPRAPHY

4. RETROGRADE PTCA 5.0 MM-5FR

5. 0.035 WIRE EXCHANGE

6. RETROGRADE STENTING-WIRE-
BASED

7. STENT DEPLOYMENT

8. FINAL ANGIOGRAPHY

9. LEFT SUBCLAVIAN ANGIOPRAPHY

10. PRE-DILATATION
• Right radial : 5F
sheath/ Simmons
catheter anterograde
injections
• Left radial: 6F sheath.
Modified LIMA guiding
retrograde injections

11. LIMA PROTECTION GUIDEWIRE
• 0.014 BMW previous to
LSC angioplasty
• Exchange LIMA
guiding by Destination
6F 90cm sheath

12. LSC CROSSING

13. STENT LANDING AND
DEPLOYMENT
7,0/29 metallic. Balloon expandable

14. STENT DEPLOYMENT AND RESULT

15. POST PCI LSC GRADIENT
Pre angioplasty
Post angioplasty

16. STUDY POPULATION
AJC 2016;118-918-23

17. PROCEDURAL DATA
AJC 2016;118-918-23

18. PROCEDURAL DATA
AJC 2016;118-918-23

19. RESULTS
AJC 2016;118-918-23

20. CLINICAL OUTCOMES
AJC 2016;118-918-23

21. LITERATURE DATA
AJC 2016;118-918-23

22. PATENCY RATE
AJC 2016;118-918-23

23. LONG-TERM FOLLOW-UP
AJC 2016;118-918-23

24. CONCLUSION
• Single access or bilateral transradial approach seems
well suited for subclavian artery stenosis or occlusion
• Current available equipment appears adequate
• Bilateral guidance and ‘guideless-technique’ is another
example of slender-type approach
• Long term results offer similar results than previous
series with brachial or femoral access with usual
additional safety benefit of radial/ulnar access