This Is MS Multiple Sclerosis Community: Knowledge & Support

interesting article in the SF Chronicle Newspaper

Radial Artery Catheterization

http://www.sfgate.com/health/article/Pa ... 683159.php



Lora

I suppose I am ok with whatever the IR has more experience with and that requires less twists or turns to get to the jugulars or that goes through larger blood vessels. The only thing would be that with the arm method the catheter would not have to traverse the heart. I am particular about my heart! Just seems like a good thing to leave alone, even if the catheter is small and it is safe and proven and etc. Some patients have had atrial fibrillation that required a night's hospital stay as a cautionary measure but not a commonly reported issue. I think it was mentioned in one of the many single center studies we've seen.

Thanks for posting the link, Ruthless, it definitely said that patients liked the arm method better than the groin.

Well personally I'd prefer the wrist entry. Possibly one would not even need to change into a hospital gown. I never liked those things! Jeans and a T-shirt would be ok?

I doubt that it would influence the outcome though.

There is a learning curve the article said, so I guess I wouldn't want to be one of the IR's first patient's for this "alternative" entry spot. No matter which entry point they start the treading of the catheter from, I still remember the discussion's from the original Dake "pioneer's" a couple of years back and the pain they had in their neck & shoulder's after the procedure. I can't remember now which of the ladies’ it was, but I remember that Lobbie was one of the guys.

Loobie wrote,


Wonder how the original pioneer's are doing now. They seem to have moved on with thier lives, but I'd sure love to hear from them all again.
Lora

Here is a link to a new article about using angioplasy instead of endarterectomy to place stents in patients with carotid artery disease. http://missoulian.com/lifestyles/health ... 963f4.html

How come they can go "Off Market" and do angeoplasties on these individuals?

Because they are doing the procedures under a research trial, CREST (Carotid Revascularization Endarterectomy vs Stent Trial)

What I would LOVE to see is these same researchers who are using angioplasy to open the arteries comming out of the heart and going into the brain (carotid arteries) in this trial, go the full circle and look at the veins that drain the blood out of the brain and look for severe stenosis in jugular veins or severe stenosis in the azygos veins.

Then we might have something!!!

But that is not the basis of this Trial, this trial is just about surgery vs angioplasy to heart patients, so sad for us..................

Lora

there are many differences from arterial catheterization and venous. Firstly, peripheral vein would provide difficulty as there are numerous valves that would have to be negoitated.
Secondly, the jugular veins, nthe most commonly involved come off at very unfavorable angles. Those difficulties may it immensely difficult to traverse the stenosed valves that are the problems
Thirdly, the jugular veins are of of such size that a larger balloons are necessary.
Fourthly those larlge balloons require large sheaths. The sheaths would destroy those small peripheral veins.
Finally, the angles between the subclavian vein and the jugular veins are very unfovorable for catheterization.

i short, I suspect that femoral acdcess is the optimal imethodology perhaps long term bus surely until large balloon profiles are no longer necessary

DrSclafani

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Salvatore JA Sclafani MD
Patient contact: ccsviliberation@gmail.com