{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,6,1]],"date-time":"2026-06-01T15:37:37Z","timestamp":1780328257409,"version":"3.54.1"},"reference-count":10,"publisher":"Oxford University Press (OUP)","issue":"2","license":[{"start":{"date-parts":[[2020,2,20]],"date-time":"2020-02-20T00:00:00Z","timestamp":1582156800000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by-nc\/4.0\/"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":[],"published-print":{"date-parts":[[2020,6,1]]},"abstract":"<jats:title>Abstract<\/jats:title>\n               <jats:sec>\n                  <jats:title>Background<\/jats:title>\n                  <jats:p>Radial access for lower-extremity peripheral vascular interventions (PVIs) has been limited due to inadequate equipment lengths. The Terumo R2P Destination Slender sheath is a relatively new sheath designed for these interventions. However, complications related to this sheath or access strategy for lower-extremity PVI have not been reported.<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>Case summary<\/jats:title>\n                  <jats:p>A 69-year-old woman presented with purple discolouration of her 1st and 5th toes of the left foot for approximately 1 month. Lower-extremity arterial duplex ultrasound showed mid left superficial femoral artery (SFA) greater than 90% stenosis. Peripheral angiogram was performed via the left radial artery and this confirmed the presence of severe left SFA stenosis. Intra-arterial vasodilators including verapamil and nitroglycerine were administered to prevent radial artery spasm. Next, we attempted to deliver the Terumo 6-Fr R2P Destination Slender 119\u2009cm sheath for the interventional procedure. However, the sheath became stuck at the level of mid axillary artery due to severe radial artery spasm. Despite use of intra-arterial vasodilators, deep sedation with propofol, and gentle retraction, the sheath could not be removed and eventually broke requiring surgical removal.<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>Discussion<\/jats:title>\n                  <jats:p>This case demonstrates severe radial artery spasm causing sheath entrapment that required emergency surgery for sheath removal. Unfortunately, the sheath could not be removed despite typical manoeuvres for severe spasm including intra-arterial vasodilators and deep sedation with propofol. Physicians performing PVIs via radial access need to be aware of this potentially serious complication.<\/jats:p>\n               <\/jats:sec>","DOI":"10.1093\/ehjcr\/ytaa038","type":"journal-article","created":{"date-parts":[[2020,2,20]],"date-time":"2020-02-20T14:40:20Z","timestamp":1582209620000},"page":"1-4","source":"Crossref","is-referenced-by-count":6,"title":["Severe radial artery spasm causing entrapment of the Terumo radial to peripheral destination slender sheath: a case report"],"prefix":"10.1093","volume":"4","author":[{"ORCID":"https:\/\/orcid.org\/0000-0001-8202-9576","authenticated-orcid":false,"given":"Salik","family":"Nazir","sequence":"first","affiliation":[{"name":"Department of Cardiology, University of Toledo Medical Center, 3000 Arlington Avenue, MS# 1118, Toledo, OH 43614, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-4975-8598","authenticated-orcid":false,"given":"Zeid","family":"Nesheiwat","sequence":"first","affiliation":[{"name":"Department of Cardiology, University of Toledo Medical Center, 3000 Arlington Avenue, MS# 1118, Toledo, OH 43614, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-8512-8104","authenticated-orcid":false,"given":"Mubbasher Ameer","family":"Syed","sequence":"first","affiliation":[{"name":"Department of Cardiology, University of Toledo Medical Center, 3000 Arlington Avenue, MS# 1118, Toledo, OH 43614, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-7428-7671","authenticated-orcid":false,"given":"Rajesh","family":"Gupta","sequence":"first","affiliation":[{"name":"Department of Cardiology, University of Toledo Medical Center, 3000 Arlington Avenue, MS# 1118, Toledo, OH 43614, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"286","published-online":{"date-parts":[[2020,2,20]]},"reference":[{"key":"2020042405555522900_ytaa038-B1","doi-asserted-by":"crossref","first-page":"e000035","DOI":"10.1161\/HCV.0000000000000035","article-title":"An update on radial artery access and best practices for transradial coronary angiography and intervention in acute coronary syndrome: a scientific statement from the American Heart Association","volume":"11","author":"Mason","year":"2018","journal-title":"Circ Cardiovasc Interv"},{"key":"2020042405555522900_ytaa038-B2","doi-asserted-by":"crossref","first-page":"430","DOI":"10.1016\/S0002-8703(99)70143-2","article-title":"Effect of transradial access on quality of life and cost of cardiac catheterization: a randomized comparison","volume":"138","author":"Cooper","year":"1999","journal-title":"Am Heart 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