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Cardiac Cath 2/08/2011: 3 Vessel CAD and LVEF 60%Left Main: No obstructionLAD: 70-80% calcific bifurcation lesions of mid LAD

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    4. Issues Involving The Case

    5. Issues Involving The Case

    6. Transfemoral Advantages

    7. Transfemoral Disadvantages

    8. Vascular Closure Devices Not a Solution

    9. Vascular Complications after Vascular Closure Devices

    11. Why Radial? The Advantages

    13. ACC-NCDR Cath PCI Registry

    14. M.O.R.T.A.L. Study British Columbia Registry

    15. Radial vs. Femoral Meta-Analysis Access Failure

    16. Radial vs. Femoral Meta-Analysis Major Bleeding

    17. Radial vs. Femoral Meta-Analysis Death, MI, or Stroke

    18. ACUITY Trial: Radial PCI Substudy

    19. Economics of Radial Access

    20. Why Radial? The Disadvantages

    21. The Learning Curve: Transradial Pitfalls Access Radial Artery Spasm Anatomical Variations Transversing the Subclavian Catheter Control and Backup

    22. Radial Access: Proximal to Styloid Process- Not really the wrist!

    23. Technical Tips for Successful Transradial Cannulation Use a 21 G x 2.5 cm thin wall needle to cannulate the radial artery Advance a 0.025 inch guidewire through the needle After the introducer is inserted, give “cocktail” of Verapamil 2 mg, lidocaine 2% (1 cc) diluted in saline, followed by 50 units/kg heparin bolus and 100-200 mcg of nitroglycerine.

    24. Radial Loop and Radial Recurrent Artery

    25. Learning Curve for Radial PCI

    26. Radiation Exposure: RAPTOR Trial

    27. Radial PCI: Contraindications

    28. Radial Artery Occlusion

    29. Prevention of Radial Artery Occlusion Patent Hemostasis

    30. Starting a Radial Program

    31. Trans-Radial Indications

    33. Take Home Message: Trans Radial PCI

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