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  • Pericardiacophrenic Artery Perforation and Radial Artery Spasm: Dealing With Complications of Transradial Coronary Angiography and Intervention

    We thank Dr. Movahed for his insightful comments  pertaining to our recently published article  . We agree that pericardiacophrenic artery or similar intrathoracic branch perforation can be a very serious complication of radial access and that deep inspiration can straighten a tortuous right subclavian-innominate artery axis, thus lowering the risk of this dreaded complication, which, as the authors mention, can be treated successfully with coil embolization. Another possible remedy is to obtain access via the left radial artery which is usually associated with less tortuosity in the left subclavian artery  and which is why some operators default to access via the left radial artery in patients over 75 or 80 years of age (even though the data to support this approach is limited  ).

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