June 8, 2020 – BD (Becton, Dickinson and Company) launched the Halo One Thin-Walled Guiding Sheath, designed to perform as both a guiding sheath and an...
This channel includes news and new technology innovations for vascular access, both venous and arterial access, for percutaneous, transcatheter, interventional devices. In cath lab procedures, an introducer sheath needs to be inserted into the vessel to allow access of guidewires, catheters and devices into the body. Introducer sheaths are self-sealing to serve a stop cock to prevent blood from leaving the body during procedures. There are various access sites that can be accessed, most commonly femoral or radial access, but also the ulnar, axillary and tibiopedal vasciular access routes There are several complications that can occur at the access site and technologies have been developed to reduce these issues, especially with the most common bleeding complications.
The Morristown Medical Center radial lounge uses recliner chairs rather than hospital beds for patients recovering from cath lab procedures using transradial access. The vascular access technique allows patients to immediately walk off the cath lab table following a procedure and they can use the bathroom and walk around during recovery. This is rapidly becoming the preferred access route in cath labs as opposed to the long-used standard of care of femoral artery access in the groin, which required hours of being immobilized in a hospital bed after the procedure, an usually an overnight stay at the hospital.
At Mayo, they have a small, tableside-mounted ultrasound console in the cath labs that is used for both radial and femoral vascular access. Table set up with the patient includes a sterile marker, a hemostat for marking the lower edge of the femoral head using fluoroscopy, a micropunture needle and a still micropunture sheath. Photo and slides courtesy of Yader Sandoval, M.D.
The Abbott Tendyne transcatheter mitral valve replacement (TMVR) system, left, became the first TMVR device to gain commercial regulatory clearance in the world. It gains European CE mark in January. Another top story in January was the first use of the Robocath R-One robotic cath lab catheter guidance system in Germany. Watch a VIDEO of the system in use in one of those cases.
The three sites most often used for distal radial artery access are the (1) anatomic snuffbox above the scaphoid (left), (2) adjacent to the snuffbox at the trapezium bone (center), and (3) the first intermetacarpal space (right). The author’s preference is either of the first two options, although good outcomes have been reported with use of the intermetacarpal space.