Table 2 Open in new tab Challenges... | Oxford Academic

Table 2

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Challenges related to vascular access in patients with heavily calcific vessels undergoing PCI

Challenge	Potential solutions
Frequent high bleeding risk patient profile	Radial approach preferred Ultrasound-guided femoral arterial puncture Reduce DAPT duration based on the bleeding risk according to guideline recommendations
Calcification in femoral arteries	Review CTA whenever available Ultrasound-guided arterial puncture
Need for 7F	7F slender sheaths for transradial access Balloon tracking or Railway inner dilator if extreme radial/brachial tortuosity Sheathless GC for transradial access

Challenge	Potential solutions
Frequent high bleeding risk patient profile	Radial approach preferred Ultrasound-guided femoral arterial puncture Reduce DAPT duration based on the bleeding risk according to guideline recommendations
Calcification in femoral arteries	Review CTA whenever available Ultrasound-guided arterial puncture
Need for 7F	7F slender sheaths for transradial access Balloon tracking or Railway inner dilator if extreme radial/brachial tortuosity Sheathless GC for transradial access

CTA, computed tomography angiography; DAPT, dual antiplatelet therapy; DES, drug-eluting stent; GC, guiding catheter.

Table 2

Open in new tab

Challenges related to vascular access in patients with heavily calcific vessels undergoing PCI

Challenge	Potential solutions
Frequent high bleeding risk patient profile	Radial approach preferred Ultrasound-guided femoral arterial puncture Reduce DAPT duration based on the bleeding risk according to guideline recommendations
Calcification in femoral arteries	Review CTA whenever available Ultrasound-guided arterial puncture
Need for 7F	7F slender sheaths for transradial access Balloon tracking or Railway inner dilator if extreme radial/brachial tortuosity Sheathless GC for transradial access

Challenge	Potential solutions
Frequent high bleeding risk patient profile	Radial approach preferred Ultrasound-guided femoral arterial puncture Reduce DAPT duration based on the bleeding risk according to guideline recommendations
Calcification in femoral arteries	Review CTA whenever available Ultrasound-guided arterial puncture
Need for 7F	7F slender sheaths for transradial access Balloon tracking or Railway inner dilator if extreme radial/brachial tortuosity Sheathless GC for transradial access

CTA, computed tomography angiography; DAPT, dual antiplatelet therapy; DES, drug-eluting stent; GC, guiding catheter.