Dr Kiemeneij I hope you had a restful weekend.
I read your book on the way home and I loved it!
I felt completely immersed in trying to understand “the way”.
I feel like I will need to read this book many more times to truly understand the complexity of all of it. One thing I have taken away is how I have always felt. More personal accomplishment with a case where all the steps have been well executed and perhaps the final result was not perfect, compared to a case where many mistakes are made in the procedure but the final result is 0% residual stenosis (or similar for oncology).

Thank you for writing this.

Regards and see you 9/2016

Darren Klass, Interventional Radiologist, Vancouver



Enjoyed reading your new transradial interzentions book. It covers many of the same concepts that ring true from my view about the approach only you put it in words and photographs!

Ian C. Gilchrist, MD, FACC, FSCAI
Professor of Medicine
Penn State Heart & Vascular Institute
M.S. Hershey Medical Center
500 University Drive, RM C-1517
Hershey, PA 17033-0850

July 3, 2016 at 2:28 pm
This book is described to perform a series of Transradial Intervention all of that in detail, but this is not just “How to Book”.
There are things about his own way with beautiful photographs written in it.
I think that his life will widely accept by next generation young physicians, and they are aiming to become a doctor like him when they finished reading this book.

Dr. Ferdinand Kiemeneij said that “TRI is not religion”. That is absolutely correct.
On the other hand, it also has the aspect as religion because everyone seeks patient’s happiness keeping less invasive therapy.
So, we all work together and achieve clinical success for the patients.
There are many problems with achieving that.
Ingenuities, unique ideas, the feeling of patient, submissive humbleness, somebody cooperation and friendship is necessary for that.
There are real ZEN.

I believe that “Transradial InterZENtions” meets the young interventional cardiologists.
He is a living legend.

TAKASHI MATSUKAGE, MD, PhD, Founder of Slenderclub Japan

Tokai University, Tokyo, Japan

BURT COHEN, founder of

With this focus on the patient and patient comfort that this technique affords, the whole experience of getting a PCI changes: for both the doctor and the patient. There are many implications generated by transradial and the future of the way interventions are done will be altered by its adoption. Hospital systems, especially in the U.S., will have to change.

But also physicians’ attitudes will. And this is why Dr. Kiemeneij’s new book is so important. In it he brings together a whole range of concepts that he has explored and has been practicing, and insights that have come from his experiences both inside and outside the hospital.


Burt Cohen’s comments on InterZENtion s at

Burt Cohen is the founder of, a great and well established site, not only following latest developments in interventional cardiology, but also paying a lot of attention to its beautiful history. Burt supports transradial coronary angioplasty and is an active promotor of this technique on his website. In the US TRI surged from 2 to 25% in a decade.

In his stent blog “The Voice In the Ear” Burt Cohen wrote some nice words on my book

InterZENtion: Transradial PCI as an Art



Transradial Coronary InterZENtions


Cover“What are you aiming at when performing a coronary intervention? Is your target a zero percent residual stenosis and normal coronary flow? Or are you aiming at a perfect procedure? This unique book by Ferdinand Kiemeneij,  combines his insights on how to optimize a transradial coronary angioplasty procedure with the most precious values of Taoist and Zen philosophies. The book is so richly illustrated with his black & white photos that it can be considered as a photo book as well. After a very short introduction into the history and principles of Taoism and Zen, the author brings some core values into the catheterization laboratory. In the end you will understand that, to speak with Herrigel: “The target is not the rose, but that the arrow leaves the arch as a leaf falls from the tree. Effortless and relaxed, without aiming it will succeed. If you shoot like this, you cannot miss because you and the target are one.” ”

This book focuses more on the ”soft” side of interventional cardiology, but in my opinion just as important as the „hard” sides. I emphasize on the importance of preparation, concentration and mindset, the denial of existence of details (everything is of equal importance), the important role of originality, intuition, traceless working, minimal material consumption.

I am sure that this book, reflecting my personal experience and way of working, will be of value to beginning interventionists, radialists and that the book is worth reading by anyone active in the cathlab.CIZ FOREWORD




Dr. Harada visits OLVG Amsterdam

Dr. Takashi Harada interventional cardiologist at Kitakyushu Municipal Yahata Hospital and member of Slender Club Japan.

He visited OLVG Hospital on March 14-15 2016 and performed PCI with dr Giovanni Amoroso, member of Slender Club Europe.

15 slender PCI procedures, among which virtual 3 french elective and acute PCI, Slender IDS stent implantations, and more.image1.JPG

Among the patients treated a 50 yr old male  with a lateral STEMI: STB 2.5 hrs

Approach: Transradial, Medikit JL 3.5 guiding sheathless for both LCA and RCA.

Culprit is RCX proximal, vessel open, no aspiration. The stenosis was treated by direct stenting with a Svelte IDS 3.0/23. The final result was excellent with a procedural time of 25 minutes. Contrast use 75 ml. The patient was discharged after two days.


IMG_6694 kopie.jpg


IMG_6695 kopie.jpg

January 12 and 13, 2015. Dr. Yoshimachi and Mr. Okajima at Tergooi, Blaricum to use the new 5F Glidesheath Slender


Almost one year after the Slender Club Europe kick-off meeting I was very pleased to receive Dr. Yoshimachi en Mr. Okajima (Terumo) at Intervention Center Tergooi, to use Terumo’s  new 5 Fr slender sheath. This sheath has almost the same outer diameter compared to the standard Terumo 4F sheath. In presence of Dr. Tavella, Verona, we used this sheath in 20 patients. In all patients the sheath was used successfully, without bleeding and without radial artery occlusion at discharge.

That evening we wrote an abstract for EuroPCR 2015. The abstract was submitted a few minutes before deadline!


SCE Masterclasses in transradial access

It always seems impossible until it’s done

This famous quote by Neslon Mandela also holds for slender TRI. If you are interested to see how slender materials and techniques are applied, you can visit the catheterization laboratories of Tergooi Hospital on each second Tuesday of the month. The whole day, maximally minimized procedures will be performed. Think of:

– 3 French sheathless CAG
– 4 French (sheathless) CAG and FFR via diagnostic catheters
– 5 French sheathless TRI
– simplified hemostasis

Most recent available materials like the sheathless 5 French Medikit system, 3 French catheters with side holes will be used. The information that you will receive is unbiased. With your own eyes you can witness the possibilities and limitations of slender techniques and of slender materials.

Ferdinand Kiemeneij, chairman SCE, will personally keep you updated on latest developments by presentations and personal interviews.

Simply mail to to reserve a place. The number of participants per session is limited to a maximum of 8 persons. The sessions, including drinks and lunch are free of costs.


Slender paper accepted for publication by EuroIntervention


Focus on maximal miniaturization of transradial coronary access materials and techniques by the Slender Club Japan and Europe: an overview and classification.


Ferdinand Kiemeneij 1, MD, PhD; Fuminobo Yoshimachi2, MD, PhD; Takashi Matsukage3, MD, PhD; Giovanni Amoroso4 , MD, PhD; Douglas Fraser 5, MD, PhD; Bimmer E. Claessen1, MD, PhD; Shigeru Saito6, MD, PhD


  1. Dpt. of Cardiology, Tergooi Hospital, Blaricum, the Netherlands
  2. Tokai University School of Medicine, Tokyo, Japan
  3. Tokai University Hachioji Hospital, Tokyo, Japan
  4. Onze Lieve Vrouwe Gasthuis, Amsterdam, the Netherlands
  5. Manchester Heart Center, Manchester, United Kingdom
  6. Kamakura General Hospital, Kamakura, Japan


Aim: To create awareness, to summarize and to classify “Slender TRI”: any technique associated with less trauma to the radial artery compared to traditional, established or recommended procedures, predominantly by reduction of French size.

Methods and results: A literature search was conducted to identify publications on slender transradial coronary interventions. Based on this search the following techniques will be described: Miniaturization of materials, sheathless coronary intervention, guideless coronary intervention and back-up improving techniques. The European perspectives will be discussed.

Conclusion: Slender TRI is a new challenge to maximize patient value by improving outcome and reducing costs during TRI. Materials and techniques are continuously being refined and miniaturized to the highest standards. If outcome improves while reducing costs remains to be validated.