Balloon asisted tracking technique in complex transradial access: A single center experience

Abstract

Aim: The transradial technique (TRA) has become widely accepted for coronary catheterization. While TRA offers numerous benefits, certain anatomical challenges can lead to access failure. Balloon-assisted tracking (BAT) has emerged as a valuable technique to overcome these challenges and improve success rates. This study aims to evaluate the feasibility and efficacy of BAT during coronary interventions using TRA.

Methods: A retrospective analysis was conducted on patients who underwent diagnostic or percutaneous coronary intervention (PCI) procedures between September 2020 and May 2023. Patient demographics, clinical data, and procedural information were collected for cases where BAT was employed to overcome radial or brachial arterial complexity.

Results: A total of 23 patients encountered anatomical difficulties necessitating BAT during the procedure, both elective and acute coronary syndrome (ACS). Radial artery spasm was the most common indication for BAT, with a high proportion of female patients. Successful completion of coronary intervention using BAT, without the need for femoral artery crossover, was achieved in all cases except one. Also, the complexity of anatomy (such as tortuosity, arterial loop, or small artery crossing) was another reason for BAT use. The mean procedural time was 47.9 minutes, and no complications related to the access site were observed.

Conclusions: The findings demonstrate that BAT is a safe and effective technique for overcoming complex radial artery anatomical challenges and radial spasm during TRA. The study supports the adoption of BAT in TRA procedures and highlights its potential benefits in both elective and ACS cases.