DOI: 10.36347/sjams.2022.v10i05.021

Pages: 798-802

Introduction: Morphological abnormalities of the arch and its branches can also be acquired with the aging of the population and cardiovascular risk factors. These arteries become deformed, dilated, and curved, making coronary exploration by the right radial approach very delicate. Objective of the study: To propose a new strategy for the approach of the right radial consisting of the use of a long, hydrophilic-coated armed introducer instead of the usual 7 cm introducers, which will allow us to compensate for the change of approach. We hope to reduce the time of scopy, the complications and the quantity of contrast medium used, through a retrospective descriptive study including 08 patients. Result: The mean age in the group was 77 years with a male/female sex ratio of 7. - The clearly predominant cardiovascular risk factor apart from age was hypertension in all groups: 62%. Eight patients with sinuosity and long armed introducer: seven with 6 Fr and 90 cm long, one with a long introducer of 100 cm and 4 Fr. The use of a long-armored introducer made it possible to perform coronary angiography in 8 patients with extreme sinuosity and coronary dilatation for the needy without any complications. The average scanning time is eight minutes for a coronary angiography. Without increasing the amount of contrast medium. In addition to the success of the coronary angiography, a control of the left mammary bypasses in two patients with tortuosities of the right subclavian and a very tortuous path could be carried out. No per-procedural complications were reported. These path anomalies were overcome with excellent support and ease through the use of the long-armed introducer. Discussion and conclusion: Anomalies of the aortic arch make coronary angiography via the right radial approach a difficult procedure. The use of a long armored hydrophilic coated introducer via the right radial approach is possible, effective and safe. It is a promising technique that is .............