Brno´s protocol

Most of the power is done from right AR. Before the procedure, we perform palpation check of the a.radialis pulsation on the right forearm. In selected cases we perform ultrasound check of the patency or diameter of the artery. Before puncture we inject 3-5ml of local anesthetic. Anterior wall puncter with 22G (0.7mm) and then we introduce Radifocus 5F RT introducer for diagnostic procedures and 6F RT or 6F RM for PCI (this is operator´s choice depends on the anatomy of the radial artery in each patient). After that, we i.a. apply 2,5mg verapamil and 5000 IU UFH (this is standard dose of UFH for diagnostic procedure; for PCI it depends on weight of pactient - 80IU/kg).

Choosing the correct band size ("standard" or L) according the size of forearm. Before pulling the sheath: about 1/3 of the sheath should be lifted before loading the TR band. Then we clean the puncture site with moistened, then dry gauze. Green marker of the TR band is placed 2-3 mm proximal to the puncture site. For the left standard radial approach, reverse orientation of the TR band (for simplicity – Terumo sign is always on little finger side). Simultaneous withdrawal of the sheath and simultaneous initial inflation of the TR band to 12 ml.