Amazing lecture, as always. Sir can you please do a talk on radial artery spasm management during left heart cath? I try not to get to that point, but once spasm develops it's difficult for the patient and for us.
Thank you. Yes, it is a difficult situation and may occasionally need to convert to a different access, but it can be handled most often with deeper sedation, vasodilators (IA/SL/SQ), and smaller catheters. I will upload soon a talk on difficult radial anatomy; in it, I briefly discuss at the end severe spasm and catheter entrapment.
I always thanks you for your kind and great lecture. But i can't understand the part that "to go from LCx to LAD"😢 How can counterclock rotation make JL catheter points more anterior? I think it may JL points more posterior, because it makes JL catheter clockwise rotation.
As I mentioned, counterclock torque points JL anteriorly if it has a hinge on the aorta (meaning, if the secondary curve is abutting the aorta). IF there is no hinge on the aorta, ie if the catheter if floating freely in the aorta like a JR, then clockwise torque will make it point anteriorly
