Access complications and management

Focused on femoral access complications.
0:00 Femoral access, ultrasound and anatomy tips
09:29 High stick and closure devices
11:57 Closure devices pitfalls-Board questions
13:15 Groin hematoma. Limited role of femo-stop device
16:17 Hypotension during or after PCI: differential diagnosis
17:58 Retroperitoneal bleeding diagnosis and management
20:40 Avoid CT scan acutely
24:15 Hazards of acute CT
27:28 Interventional management of RP bleed: steps and techniques
33:05 Bleeding from a small branch management
34:55 Femoral neuropathy
35:53 Femoral Pseudoaneurysm TRUE DEFINITION and diagnosis
42:34 Femoral Pseudoaneurysm management (including thrombin technique)
47:31 Femoral AV fistula diagnosis
48:55 Femoral AV fistula management
52:44 Limb ischemia
54:16 Interventional management of limb ischemia from closure device
57:09 Retrograde iliac dissection
01:00:19 Radial access complications
01:00:19 Radial pseudoaneurysm management
01:03:39 Radial hematoma
01:04:44 Compartment syndrome thought process and management

[@ratman811]

I think the world is ready for a book about interventional cardiology (mainly coronary) by Dr Hanna

[@mr.doctor.]

Briliant lecture as usual! If you will publish an interventional cardiology book, I will buy it for sure!

[@muhammadabubakar7649]

Great lecture by a great teacher thanks dr Elias hanna

[@chichunau9668]

Thank you so much for the great lecture!

[@bassamalsideq2709]

Brilliant lecture as usual prof Elias 🙏🙏Thanks for lighting the path to knowledge.

[@aroojzahid3138]

Very nicely elaborated lecture.
Kindly upload CTO intervention literature as well

[@deepakk7067]

Thank you, Dr. Hanna. I’m a community Intensivist, who works closely with cardiologists. regarding ordering CTA scan for these patients. Can we not use compression while we wait for CT and use compression during transport? (Albeit it has to be femstop]] if I have a cardiologist like you who will evaluate the patient and take them back to Cath Lab when they are hemodynamically unstable despite compression/resuscitation, I can avoid CT scan. but my community cardiologists neither come back to see the patient nor will they take them to Cath Lab unless I show them an active contrast extravasation. Quite often they have to put covered stents over the area of bleed to stop it. I have lost patients due to this. My only way out is a CTA showing an active bleed.
Once again, thank you for all the teaching you do. Helps me deliver better care to patients/teachers my residents

[@ahmeddaoud9901]

Awesome Lecture as Usual Thanks a lot

[@Saleemyousuf1990]

Thank you for the great lecture..... I have noticed over years, rarely in some of our patients they would develop lower abdominal wall hematoma.....is it due to inf epigastric artery injury....???
Also what is to be done if retrograde iliac dissection is obstructive with no flow on Doppler...??

[@Ubiqes]

Hello. Thank you for very useful information, as always. I just want to tell: In my experience, ultrasound guided compression on pseudoaneurysm of the radial artery is very successful and fast procedure.

[@eliashanna8248]

Thank you! And thank you for sharing your tip.

[@vvasavvat]

Thank you !!!!

[@mariusz88w]

PCI after TAVI - please ! ;)

[@adamp9218]

Thank you for the video. Can you do a video on RHC and also go over how to get a PA catheter into PA from femoral approach. Would appreciate it.

[@Nikesnipe]

Thanks a lot

[@kam12379]

I have always found that using a sharp angle is very useful in visualizing the needle in femoral access however i was told that with large bore access the angle of entry must be 45 degrees or else the closure devices won't function properly and result in bleeding. What do u think about this point.
Thank you for the lecture

[@eliashanna8248]

I do not believe so. I usually slightly drop the needle angle after using a sharp angle entry. What is important in that regard is to access the artery from the top rather than from the side (that is avoid angling the needle medially or laterally). Side access likely increases bleeding but also closure failure and complications (potentially also limb ischemia)