Technical considerations in performing radial procedures

Although there are many articles extolling the potential benefits of radial procedures, there are fewer reviews that deal with the ‘nitty gritty’ technical aspects needed to perform the procedures. What catheterization lab equipment is needed to convert from femoral procedures and are there technical tricks that can facilitate coronary arteriography in radial procedures? This article discusses some of these considerations. Converting to a radial procedure Any catheterization suite that performs femoral procedures can perform radial studies. The most important piece of equipment is a wide arm board to support the patient’s arm and provide an adequate platform between the arm and the patient’s body to rest the angiographer’s equipment. Typically, the patient’s arm is placed close to the body. Most procedures utilize the right radial artery, but the left can be used based on the patient’s anatomy (particularly for tortuosity of the right subclavian artery) and the type of procedure performed, e.g. need to cannulate the left internal thoracic artery.