Brachial Artery Access Jeffrey Wang MD Horizon Vascular

Brachial Artery Access Jeffrey Wang, MD Horizon Vascular Specialists Director of Vascular Research Shady Grove Adventist Hospital

Jeffrey Wang, MD I have no relevant financial relationships

Brachial Access • Techniques • Tips • Complications

Technique Brachial Access • • • Pt supine arm extended Palpate brachial artery pulse The use of ultrasound is highly recommended Infiltrate lidocane Access over the Olecranon

Ultrasound Guided Brachial Access

Tips for Brachial Access Use a micropuncture needle Anticoagulate as soon as access is confirmed For a small artery vasodilators Utilize the left arm when possible to avoid crossing the arch vessels • Will require longer sheaths and devices • •

Complications • Complication involving the brachial artery approximately 6. 5% – majority pseudoaneurysm and thrombosis of the brachial artery

Complications • Pseudoaneurysms – Observation – Injection – Operation • Hematomas – Observation(No motor or sensory dysfunction) – Immediate operation if motor or sensory loss

Thrombosis • Open • Endovascular

Conclusion • Safe and effective • Very helpful in mesenteric, renal and proximal lower extremity • Must exercise caution • Complications are typically more urgent