Aims and objectives
Interest in radial access (RA) for non-coronaric interventional procedures is gradually increasing with mounting evidence of its safety and feasibility (1).
Compared to transfemoral access,
it has shown improved post-procedure hemostasis and patient satisfaction,
decreased haemorrhagic complications,
and procedure-related costs (2)(3,4).
Reasons for under- use of TRA outside the cardiac catheterization laboratory may include operator unfamiliarity,
a lack of appropriate training,
equipment limitations such as inappropriate catheter length and shape,
and the initial learning curve (1) (5).
RA has a steep...
Methods and materials
Proof of concept was demonstrated using Thiel-embalmed human cadaver with extracorporeal arterial flow.
The Thiel cadaver was placed supine. The extracorporeal circuit was prepared by inserting ports (12 – 14 Fr sheath,
Check-Flo Cook Medical,
Ireland) into the left axillary and femoral arteries (depending upon the caliber of the vessel); the ports were then connected to a heart–lung bypass machine (HL-30 Maquet,
Germany). Extracorporeal continuous retrograde flow of up to 1 L per minute was delivered to the arterial tree depending upon the flow rate...
coronary angiogram and coronaroplasty,
renal and lower limbs angiography and angioplasty were performed by an interventional radiologist,
showing the patency and accessibility of these vessels through the RA.
A balloon expandable stent was released in the right common iliac artery.
Stent placement was evaluated by fluoroscopic and DSA angiography.
All endovascular procedures were conducted under fluoroscopic guidance using contrast.
Thiel cadavers have the potential to provide a robust and realistic simulation training model for fellows and consultants who want to improve or practice interventions and demonstrate competency.
Current limitations in training with radial access using this cadaveric model are the lack of complications related to RA,
such as bleeding or occlusion,
pseudoaneurysm and nerve damage,
which are currently not simulated within this model. Further model development within a curricular framework may address this issue.
Training endovascular peripheral intervention through RA...
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