Dr. Rajiv Tayal is an interventional cardiologist at Valley Health System in Paramus, New Jersey.
Visit Valley Health System to learn more about Dr. Rajiv Tayal.
Podcasts
CathMasters # 10Aug 2, 2026Crisis Control - Bailout Management for Failed Percutaneous Axillary Artery Closure
Building on the Data-to-Delivery and Proctor Playbook episodes, this Crisis Control episode walks through a scenario of wide-open extravasation after Perclose failure during right axillary access TAVR. The team covers a stepwise escalation algorithm — from repeat Perclose deployment and serial balloon tamponade with protamine reversal, to hybrid closure with AngioSeal, to covered stent placement with the Viabahn endoprosthesis — and discusses when to call vascular surgery. This episode translates the 2022 SCAI Position Statement bailout recommendations into a practical, cath-lab-ready crisis management framework.
- CathMasters # 9Jul 10, 2026
Proctor Playbook - Percutaneous Transaxillary Access & Closure: State-of-the-Art Technique
Using a simulated case of Impella-supported high-risk PCI in a patient with severe bilateral iliofemoral PAD, the team walks through a step-by-step proctor playbook: pre-procedural CTA planning, laterality selection, room and arm setup, axillary artery anatomy, ultrasound-guided access technique, safety wire strategy, pre-closure with suture-mediated vascular closure devices, dry closure with balloon tamponade, and a bailout algorithm for failed hemostasis. This episode translates the 2022 SCAI Position Statement on Best Practices for Percutaneous Axillary Arterial Access into actionable, cath-lab-ready technique. Episode 8 reviews the evidence base for this technique in the “Data-to-Delivery” discussion and Episode 10 will tackle vascular complication management with transaxillary access in the “Crisis Control” discussion.
- CathMasters # 8Jul 6, 2026
Data to Delivery: Percutaneous Transaxillary Arterial Access & Closure
Approximately 5% of US TAVR cases require alternative access despite lower-profile devices, and with expanding indications for TAVR and mechanical circulatory support (MCS), the absolute number of patients needing non-femoral large-bore access is rising. This “Data to Delivery” episode reviews the comparative outcomes of transaxillary access for TAVR and MCS, the stroke signal and laterality debate, vascular complications of percutaneous versus surgical approaches, brachial plexus injury risk, dwell-time considerations for axillary MCS, and the learning curve for this technique.