Clinical ResearchTransradial Approach for Left Ventricular Endomyocardial Biopsy
Section snippets
Methods
Patients who underwent LV-EMB via radial arterial access from 3 centres (Canada, Germany, and Japan) were retrospectively evaluated. All procedures were performed by experienced operators who perform most of their coronary interventions via radial access. Patients who had attempted transradial LV-EMBs but then necessitated conversion to transfemoral access were also included.
Population and preprocedural characteristics
A total of 102 patients who underwent transradial LV-EMB were identified. The median age was 57 (48–68) years, and approximately half (57%) of the patients were male. The median LVEF was 35% (25%–44%). For all but 1 patient, it was their first LV-EMB procedure, with dilated cardiomyopathy (43%), infiltrative cardiomyopathy (25%) or myocarditis (20%) making up the primary indications for LV-EMB. The demographics of the patients are detailed in Table 1.
Access, sheath and guide catheters
All patients but 1 underwent right radial
Discussion
This article reports a case series of transradial LV-EMB that was associated with a high rate of success, coupled with an extremely low rate of complications. Transradial LV-EMB has been previously reported in isolated case reports and small single-centre experiences.10, 11, 12, 14 The strength of the current study lies in its multicentre and international nature including more than 100 patients. The current series lends further weight to the feasibility and safety of transradial LV-EMB despite
Conclusions
In this case series, the transradial route appears to be a safe and highly effective way to perform LV-EMB. Whether transradial LV-EMB is safer and more effective than transfemoral LV-EMB can only be determined by head-to-head comparisons or a much larger observational data. Given the positive experience of transradial coronary interventions over transfemoral interventions that includes essentially eliminating life-threatening access-site complications and the widespread adoption of radial
Disclosures
The authors have no conflicts of interest to disclose.
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Cited by (7)
Transradial left ventricular endomyocardial biopsy feasibility, safety and clinical usefulness: Initial experience of a tertiary university center
2020, Revista Portuguesa de CardiologiaCitation Excerpt :Indeed, in the setting of myocarditis, the largest published series reports a 92.1% vs. 81.3% diagnostic yield,4 and in the setting of predominant LV disease, the difference is quite large and the LV approach is favored with 97.8% vs. 53%, respectively.3 Published data from the transradial approach do not allow for a comparison of left versus right approaches, however the conclusions are similar to ours: the results added to the clinical dilemma, confirming, excluding or clarifying a diagnostic hypothesis.13 Despite its advantages, the transradial LV endomyocardial biopsy technique is not without limitations.
Radial versus femoral approach for saphenous vein grafts angiography and interventions
2019, American Heart JournalThe Right Way to the Left Ventricle: A Better Approach to Endomyocardial Biopsy?
2018, Canadian Journal of CardiologyIs this the prime time for transradial access left ventricular endomyocardial biopsy?
2021, Interventional Cardiology: Reviews, Research, ResourcesThe safety and feasibility of transitioning from transfemoral to transradial access left ventricular endomyocardial biopsy
2020, Journal of Invasive CardiologyRadial versus femoral approach for left ventricular endomyocardial biopsy
2019, EuroIntervention
See editorial by Giraldeau, pages 1247–1249 of this issue.
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