Left Radial Support Sling

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A collaboration between South Tees Hospitals NHS Foundation Trust and Amdel Medical.

The Left Radial Support Sling was an idea developed by Senior Cardiac Radiographer Sue Best, at South Tees Hospitals NHS Foundation Trust.

The Radial Support Sling is designed to overcome various problems associated with a left radial access coronary angiography.

A coronary angiography is completed to assess the patency of the vessels which supply the heart muscle with blood. A catheter is inserted into the cardiovascular system and located in the coronary arteries feeding the heart. When the catheter is in the correct position a high attenuation contrast agent is injected into the blood vessels to enable coronary blood flow to be visualised under x-ray fluoroscopy. The comfort of the patient is an important issue as the procedure can be prolonged.

The catheter can be inserted into a femoral or radial artery. Recent evidence suggests that radial access should be used in preference to femoral access as it is less painful for the patient, recovery time is shorter and the patient is less likely to require a bed overnight.

The configuration of the angiography theatres is such that the surgeon stands to the right of the patient and the x-ray equipment and monitors are located on the left of the patient, therefore arterial access is generally gained from the right. However, in certain circumstances a left access may be required, for example when there are problems with right radial access or when the patient has undergone coronary artery bypass grafting. The positioning of the x-ray equipment and monitors prevents the surgeon from standing on the left side of the patient hence the surgeon must lean over the patient to position the catheter into the artery.

This uncomfortable position for both the patient and the surgeon does in many cases result in the surgeon using a femoral approach rather than a radial approach with the resulting increase in discomfort and time in hospital for the patient.

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