Chapter 2: Patient Preparation: Left Radial Access Setup in the Cath Lab

The left radial approach is an important alternative to standard right radial access with significant advantages, especially in specific settings of the population (i.e., patients with previous coronary artery bypass or aged patients). However, many physicians do not appreciate the left radial access because of a remarkable discomfort that is more pronounced at the back level. When performing a procedure through the left radial access, the operator must bend over the patient during the procedure, which increases the workload of the back region. Another limitation is the concept that the operator has to place himself to the left side of the patient and the traditional laboratory setup has to be rearranged, but typically, this is not the case. In this chapter we will describe the patient preparation for a comfortable left transradial approach. This is a fundamental step before performing a diagnostic or interventional coronary procedure through the left transradial approach and must be optimized in order to increase the operator comfort without modifying the usual cath lab setup or the operator position. An incorrect patient preparation is responsible for most difficulties and discomfort reported by operators during left transradial access.

Alessandro Sciahbasi, MD