Case 183: Manual of PCI - Access problems

[@shangz0216]

Thanks for the excellent case presentation.

[@denizaktürk-j7n]

Is there a clear classification for RAS?

[@tom11298]

Amazing learning points Although refractory RAS is rare, having lower threshold of using US guided femoral access when RAS is relevant/the guide just becomes difficult to maneuver despite initial radial cocktail or when the radial is too small, is helpful.

[@shamsrehan8942]

Wao, amazing, learnt alot

[@jwilson3985]

Yikes. When PCI is the easiest part in a big patient you know it was a rough one. Did you try using an Amplatz SS or Lundequist for the Perclose?

[@Stentordoc]

Tough case! Cases like this remind me why I’m glad I’m still a dinosaur who uses femoral access 95% of the time. And a Starclose sheath likely would have been able to navigate that iliac tortuosity