MCQ 36: PCI through radial route

Q. Advantages of choosing left radial artery over right radial artery during trans-radial PCI are all except?
A. Prevalence of subclavian artery tortuosity and radial artery loops are three times more common in right radial artery
B. Hooking of LIMA is easier from left radial artery
C. Learning curve is short in left radial route than right
D. Incidence of radial artery spasms is more in right radial artery

Answer: D. Incidence of radial artery spasms is more in right radial artery

Explanation:

PCI from left radial route has many advantages as compared to right artery. Prevalence of radial artery loops and subclavian artery tortuosity are more three times more common on right side. Learning curve is longer in right radial artery and hooking of left internal mammary artery (after CABG) is difficult from the right radial route because it involves crossing to the opposite side from the aortic arch. However, the incidence of radial artery spasms during the procedure is same in both the sides (~3.5%).

ECG Spotter

What is the diagnosis? Click the button below to view answer: Show Answer

MCQ

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Coronary artery perforation

Management of coronary artery perforation 1. Balloon inflation for occlusion of vessel 2. General circulatory support → Intravenous fluids and vasopressors 3. Urgent pericardiocentesis if cardiac tamponade (may consider autotransfusion) 4. Call anaesthetist and inform surgeons. Repeat angiogram ↓ Extravasation settled → Yes → Monitor patient ↓ No # Large vessel perforation 1. Prolonged balloon inflation 2. Covered stent placement # Small distal vessel perforation 1. Embolization (fat, coils, thrombin, balloon fragment) 2. Covered stent in main vessel over perforated branch origin

Learning Cardiology

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