Pénétration de l’approche radiale dans le monde et apprentissage de la technique

The transradial approach has been used for the first non selective coronary angiographies but was quickly replaced by the femoral approach until a new birth in 1989 for coronary angiography in 1989 and coronary angioplasty in 1992. Transradial approach use is extremely heterogeneous in the world, dominated by some countries in Europe, Canada, and eastern Asia (India, Taiwan, China, Japan).Risk factors of failure have been well described, allowing two kinds of learning: systematic attempt in all kind of patients when working with a proctor; patient selection when beginning the technique alone in order to get a high and stable success rate from the beginning. Systematic radial approach for coronary angiography is a must to learn the technique.     

Les frontières du bilan allergologique en allergo-anesthésie

Anesthesia is a situation during which patients are exposed to a large number of drugs in a very short period of time. Almost all of such products may be incriminated as the cause of a hypersensitivity reaction. We conducted a retrospective analysis that included 171 patients who had had an allergy workup in the General Allergy Unit at the Angers CHU following a reaction which occurred during the course of a general or locoregional anesthesia between January 2000 and January 2007. The results of this analysis led us to raise some questions related to the interpretation in a number of these cases, i.e., the results suggesting polysensitization on the one hand, whereas, on the other hand, the tests were negative when done during the course of severe grade III reactions. These two points, which have not been considered up to the present in multicentric studies on the prevalence and the risk of peri-anesthesic allergic reactions, are the subject of the present article.