Recent remarkable developments in PCI devices make it possible to treat ever more complex lesions. Use of the 6 Fr brachial IABP access for prophylactic use in triple-vessel and left main interventions is a new approach discussed in detail in the December issue.
Fujii et al
Feasibility of 6 Fr Intra-Aortic Balloon Pumping Via the Femoral or Brachial Approach
Toshiharu Fujii, MD, Naoki Masuda, MD, Takeshi Ijichi, MD, Yoshinari Kamiyama, MD, Shigemitsu Tanaka, MD, Gaku Nakazawa, MD, Norihiko Shinozaki, MD, PhD, Takashi Matsukage, MD, PhD, Nobuhiko Ogata, MD, PhD, Yuji Ikari, MD, PhD
Good News on Alternatives to the Femoral Approach for Hemodynamic Support
By Bruce Kuo, MD and H. Vernon Anderson, MD
Discussion of the feasibility for 6 Fr brachial IABP access for prophylactic use in triple-vessel and left main interventions. It is not entirely clear whether the reported benefit in Fujii et al derives more from a difference in access sites, brachial versus femoral, or a difference in sheath sizes (6 Fr vs 8 Fr). Typically, the major vascular complication of brachial artery access is thrombosis, whereas the major vascular complication of femoral artery access is bleeding. As the sheath size becomes smaller, the bleeding complications would be reduced. Therefore, how much each factor contributes to the overall reduction in bleeding is still unclear.