Brachial approach to NOGA-guided procedures: Electromechanical mapping and transendocardial stem-cell injections

Marko Banovic, Miodrag C. Ostojic, Jozef Bartunek, Milan Nedeljkovic, Branko Beleslin, Andre Terzic

Research output: Contribution to journalArticlepeer-review

5 Scopus citations


Several methods are available for delivering stem cells to the heart. Recent studies have highlighted the advantages of injecting the cells directly into the myocardium in order to increase myocardial retention of cells. A particular focus has been on percutaneous transendocardial injection, facilitated by electromechanical mapping. The NOGA® XP Cardiac Navigation System has a multicomponent catheter that is designed to guide and deliver transendocardial injections via a transfemoral approach, without a guidewire. However, this method may not be feasible in some patients who have peripheral vascular disease. Herein, we describe the case of a 68-year-old man whose tortuous, sharply angled iliac arteries precluded a femoral approach to transendocardial injection. To overcome the anatomic and mechanical challenges, we used a brachial approach. We believe that this is the 1st report of using the brachial route for transendocardial injection, and that it can be a viable alternative to the transfemoral approach in selected patients.

Original languageEnglish (US)
Pages (from-to)179-182
Number of pages4
JournalTexas Heart Institute Journal
Issue number2
StatePublished - Apr 28 2011


  • Biological products/therapeutic use
  • Coronary vessels/pathology
  • Electrophysiologic techniques, cardiac/instrumentation/methods
  • Heart diseases/therapy
  • Imaging, three-dimensional
  • Injections
  • Myocardial infarction/pathology
  • Regenerative medicine/methods
  • Stem cell transplantation/methods
  • Treatment outcome

ASJC Scopus subject areas

  • Cardiology and Cardiovascular Medicine


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