Background to LDTRA and DRAWS
Left Distal Trans Radial Access (LDTRA)
• The left distal radial artery is palpable within the intersection of the thumb and first finger over the boney structures of the anatomical snuff-box on the dorsum of the hand.
• Now a common access site.
• Left radial artery is the preferred access site in the following situations:
– Diminished right radial pulse.
– History of coronary artery bypass graft surgery, particularly in presence of a left internal mammary artery graft.
• Standard cardiac catheterization laboratory is arranged with the physician standing on the right side of the patient and the radial artery is entered on the palmer side of the forearm.
• For access to the left radial artery the patient’s left arm needs to be brought across the patient’s abdomen.
– NOT always possible secondary to patient specific limitations:
– Patients inability to supinate their wrist due to orthopedic limitations within their shoulder and/or elbow.
– Patient’s body habitus.
• To use the dorsum of the patient’s hand for radial artery access results in a more natural and typically more comfortable position for both the patient and physician.
• The dorsal radial artery is best accessed when the wrist is in a neutral position with the thumb side up.
For further information regarding LDTRA refer to: Back hand approach to radial access
Development of DRAWS (Patent Pending)
• Development of this support board resulted from limitations of current support devices.
• A short video explaining application of the DRAWS product: Video