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Clinical situations requiring radial or brachial access during carotid artery stenting. ADVANCES IN INTERVENTIONAL CARDIOLOGY 2020; 16:410-417. [PMID: 33598013 PMCID: PMC7863832 DOI: 10.5114/aic.2020.101765] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/30/2020] [Accepted: 06/29/2020] [Indexed: 11/17/2022] Open
Abstract
Introduction Radial or brachial access may be preferred in the case of severe peripheral artery disease (PAD) or difficult aortic arch anatomy during carotid artery stenting (CAS). Aim To evaluate the clinical conditions indicating potential benefit from non-femoral access as well as feasibility and safety of transradial/transbrachial access (TRA/TBA) as an alternative approach for CAS. Material and methods Since 2013, 67 patients (mean age: 70 years old, 44 men, 42% symptomatic) were selected for CAS with the TRA/TBA approach. The composite endpoint was stroke/death/myocardial infarction within 30 days of the procedure and compared to the propensity score matched transfemoral approach (TFA) group. Clinical (including neurological) examination and Doppler ultrasonography were performed before the procedure, at discharge and at 30 days. Results CAS with TRA/TBA was successful in 63/67 patients. Transfemoral access was not feasible due to PAD in 35 (52.2%) patients, bovine arch in 10 (14.9%), obesity (BMI > 35 kg/m2) in 9 (13.4%), severe degenerative disease of the spine in 7 (10.5%), arch type III in 5 (7.5%) and excessive subclavian stent protrusion in 1 (1.5%) patient. Mean NASCET carotid artery stenosis was reduced from 81% to 9% (p < 0.001). The composite endpoint occurred in 3 (4.8%) cases and it was not statistically significantly different from the matched TFA group (6.3%; p = 0.697). No access site complications requiring surgical intervention or blood transfusion developed. Conclusions Transradial and transbrachial CAS may be an effective and safe procedure, and it may constitute a viable alternative to the femoral approach in patients with severe PAD, difficult aortic arch anatomy or obesity.
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Balaban Y. Effectiveness of a handmade "New Carotid Catheter" in transradial carotid angiography: A comparison with conventional multipurpose catheters. J Interv Cardiol 2017; 31:94-105. [PMID: 29024265 DOI: 10.1111/joic.12454] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/06/2017] [Revised: 09/11/2017] [Accepted: 09/13/2017] [Indexed: 11/30/2022] Open
Abstract
OBJECTIVE The incidence and severity of carotid atherosclerosis increases in proportion with coronary artery disease and its severity. A special catheter specifically used for transradial carotid angiography has not yet been marketed. In this study, we investigate the feasibility and safety of our carotid catheter, which was made by reshaping currently available catheters. METHODS Between 2010 and 2017, a total of 921 patients with indications for carotid angiography were identified after angiographic examinations and included in the study. Carotid angiography was performed in 403 patients (female, n = 161) using the 3.5 JL catheter, while in 518 (female, n = 207) patients, new catheters were employed. The new catheter was shaped like a hook in the laboratory with a heat gun. Demographic information and angiographic data from the patients in both groups were retrospectively analyzed. RESULTS The baseline characteristics of both groups were comparable. When compared with the use of a 3.5 JL catheter, right transradial carotid angiographies performed with our new handmade catheter resulted in lesser amounts of opaque material used (55 mL vs 66 mL, P < 0.001) and shorter total fluoroscopy time, (3.60 ± 1.85 min vs 3.14 ± 1.55 min, P < 0.001). The handmade catheter also resulted in a higher success rate of selective visualization (97% vs 40%, P < 0.001). Rates of minor complication were comparable between the two catheters (6.5% vs 6.6% P = 234). Neither permanent damage nor morbidity or mortality was observed in either arm. DISCUSSION Currently available catheters and methods are inadequate for routine transradial carotid angiography. For routine transradial carotid angiography, innovatively designed catheters are required. The catheter we developed for transradial carotid angiography was more successful than the conventional catheter in obtaining satisfactory images. High quality images can be obtained with the newly designed catheters. CONCLUSION Transradial carotid angiography can be performed using our newly developed carotid catheter. The carotid arteries of patients with widespread coronary artery disease can be visualized, while asymptomatic patients carrying a high risk of stroke can be treated, preventing potential stroke occurrence. In a larger-scale comparative study, the favorable contributions of routine use of the new method and a decreased frequency of stroke may be demonstrated.
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Affiliation(s)
- Yakup Balaban
- Vm Medical Park Kocaeli Hospital, Department of Cardiology, Başiskele, Kocaeli, Turkey
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Basu D, Singh PM, Tiwari A, Goudra B. Meta-analysis comparing radial versus femoral approach in patients 75 years and older undergoing percutaneous coronary procedures. Indian Heart J 2017; 69:580-588. [PMID: 29054180 PMCID: PMC5650575 DOI: 10.1016/j.ihj.2017.02.003] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/25/2016] [Revised: 01/24/2017] [Accepted: 02/06/2017] [Indexed: 01/19/2023] Open
Abstract
Introduction Elderly patients (≥75 years) undergoing coronary angioplasty are increasing. Meta-analyses have shown the benefits of radial access which might reduce hospital stay by decreasing access site complications with associated secondary benefits, however, the population over the age of 75 years were not a large part of the cohort and may behave differently due to increased atherosclerotic burden and age-related vascular changes. In addition, complications unique to this age group such as delirium and deconditioning might occur which could have a bearing on the outcome. Methods We searched Pubmed, SCOPUS, Medline, Dynamed, Cochrane. The search terms used were femoral and radial, femoral versus radial, radial or femoral access site, radial or femoral comparison. There were no restrictions. Results There was a significant decrease (85%)in the incidence of access site complications in the radial group. The time to achieve ambulation was lower by 14.25 h (8.86–19.56 h). However, the incidence of crossover (in effect failure to perform catheterization by radial access) from radial to femoral was significantly higher. Radial access was associated with longer procedural times (2.75 min) and increased contrast dose however, there was no statistical difference in the fluoroscopy time between the two. Conclusions Radial access has similar benefits in elderly patients as those under the age of 75 and may be beneficial in patients at risk of delirium or deconditioning. However, crossover rates, contrast dose and procedure time were higher. It is conceivable that as experience is gained, these rates will diminish.
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Affiliation(s)
- Dev Basu
- Medstar Good Samaritan Hospital, Baltimore, MD, United States.
| | | | | | - Basavana Goudra
- Hospital of the University of Pennsylvania, Philadelphia, PA 19104, United States
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Simard T, Hibbert B, Natarajan MK, Mercuri M, Hetherington SL, Wright R, Delewi R, Piek JJ, Lehmann R, Ruzsa Z, Lange HW, Geijer H, Sandborg M, Kansal V, Bernick J, Di Santo P, Pourdjabbar A, Ramirez FD, Chow BJW, Chong AY, Labinaz M, Le May MR, O'Brien ER, Wells GA, So D. Impact of Center Experience on Patient Radiation Exposure During Transradial Coronary Angiography and Percutaneous Intervention: A Patient-Level, International, Collaborative, Multi-Center Analysis. J Am Heart Assoc 2016; 5:JAHA.116.003333. [PMID: 27247332 PMCID: PMC4937274 DOI: 10.1161/jaha.116.003333] [Citation(s) in RCA: 16] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/15/2022]
Abstract
Background The adoption of the transradial (TR) approach over the traditional transfemoral (TF) approach has been hampered by concerns of increased radiation exposure—a subject of considerable debate within the field. We performed a patient‐level, multi‐center analysis to definitively address the impact of TR access on radiation exposure. Methods and Results Overall, 10 centers were included from 6 countries—Canada (2 centers), United Kingdom (2), Germany (2), Sweden (2), Hungary (1), and The Netherlands (1). We compared the radiation exposure of TR versus TF access using measured dose‐area product (DAP). To account for local variations in equipment and exposure, standardized TR:TF DAP ratios were constructed per center with procedures separated by coronary angiography (CA) and percutaneous coronary intervention (PCI). Among 57 326 procedures, we demonstrated increased radiation exposure with the TR versus TF approach, particularly in the CA cohort across all centers (weighted‐average ratios: CA, 1.15; PCI, 1.05). However, this was mitigated by increasing TR experience in the PCI cohort across all centers (r=−0.8; P=0.005). Over time, as a center transitioned to increasing TR experience (r=0.9; P=0.001), a concomitant decrease in radiation exposure occurred (r=−0.8; P=0.006). Ultimately, when a center's balance of TR to TF procedures approaches 50%, the resultant radiation exposure was equivalent. Conclusions The TR approach is associated with a modest increase in patient radiation exposure. However, this increase is eliminated when the TR and TF approaches are used with equal frequency—a guiding principle for centers adopting the TR approach.
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Affiliation(s)
- Trevor Simard
- Division of Cardiology, University of Ottawa Heart Institute, Ottawa, Ontario, Canada
| | - Benjamin Hibbert
- Division of Cardiology, University of Ottawa Heart Institute, Ottawa, Ontario, Canada
| | - Madhu K Natarajan
- Division of Cardiology, Hamilton Health Sciences, Hamilton, Ontario, Canada
| | - Mathew Mercuri
- Division of Cardiology, Hamilton Health Sciences, Hamilton, Ontario, Canada Division of Cardiology, Department of Medicine, Columbia University, New York, NY
| | | | - Robert Wright
- James Cook University Hospital, Middlesbrough, United Kingdom
| | - Ronak Delewi
- Academic Medical Center, University of Amsterdam, The Netherlands
| | - Jan J Piek
- Academic Medical Center, University of Amsterdam, The Netherlands
| | - Ralf Lehmann
- Johann Wolfgang Goethe-University Frankfurt, Frankfurt, Germany
| | - Zoltán Ruzsa
- Cardiac and Vascular Center, Semmelweis University, Budapest, Hungary
| | - Helmut W Lange
- Kardiologisch-Angiologische Praxis Herzzentrum Bremen, Bremen, Germany
| | - Håkan Geijer
- Department of Radiology, School of Medical Sciences, Örebro University, Örebro, Sweden
| | - Michael Sandborg
- Radiation Physics, Department of Medical and Health Sciences, Center for Medical Image Science and Visualization, Linköping University, Linköping, Sweden
| | - Vinay Kansal
- Faculty of Undergraduate Medicine, University of Ottawa, Ontario, Canada
| | - Jordan Bernick
- Cardiovascular Research Methods Center, Ottawa, Ontario, Canada
| | - Pietro Di Santo
- Division of Cardiology, University of Ottawa Heart Institute, Ottawa, Ontario, Canada
| | - Ali Pourdjabbar
- Division of Cardiology, University of Ottawa Heart Institute, Ottawa, Ontario, Canada
| | - F Daniel Ramirez
- Division of Cardiology, University of Ottawa Heart Institute, Ottawa, Ontario, Canada
| | - Benjamin J W Chow
- Division of Cardiology, University of Ottawa Heart Institute, Ottawa, Ontario, Canada
| | - Aun Yeong Chong
- Division of Cardiology, University of Ottawa Heart Institute, Ottawa, Ontario, Canada
| | - Marino Labinaz
- Division of Cardiology, University of Ottawa Heart Institute, Ottawa, Ontario, Canada
| | - Michel R Le May
- Division of Cardiology, University of Ottawa Heart Institute, Ottawa, Ontario, Canada
| | - Edward R O'Brien
- Libin Cardiovascular Institute of Alberta, Calgary, Alberta, Canada
| | - George A Wells
- Cardiovascular Research Methods Center, Ottawa, Ontario, Canada
| | - Derek So
- Division of Cardiology, University of Ottawa Heart Institute, Ottawa, Ontario, Canada
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Ruzsa Z, Nemes B, Pintér L, Berta B, Tóth K, Teleki B, Nardai S, Jambrik Z, Szabó G, Kolvenbach R, Hüttl K, Merkely B. A randomised comparison of transradial and transfemoral approach for carotid artery stenting: RADCAR (RADial access for CARotid artery stenting) study. EUROINTERVENTION 2015; 10:381-91. [PMID: 25042266 DOI: 10.4244/eijv10i3a64] [Citation(s) in RCA: 88] [Impact Index Per Article: 9.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/28/2022]
Abstract
AIMS Limited data exist on radial access in carotid artery stenting. This multicentre prospective randomised study was performed to compare the outcome and complication rates of transradial and transfemoral carotid artery stenting. METHODS AND RESULTS The clinical and angiographic data of 260 consecutive patients with high risk for carotid endarterectomy, treated between 2010 and 2012 by carotid stenting with cerebral protection, were evaluated. Patients were randomised to transradial (n=130) or transfemoral (n=130) groups and several parameters were evaluated. Primary combined endpoint: major adverse cardiac and cerebral events, rate of access-site complications. Secondary endpoints: angiographic outcome of the procedure, fluoroscopy time and X-ray dose, procedural time, crossover rate to another puncture site and hospitalisation in days. Procedural success was achieved in all 260 patients (100%), the crossover rate was 10% in the TR and 1.5% in the TF group (p<0.05). A major access-site complication was encountered in one patient (0.9%) in the TR group and in one patient (0.8%) in the TF group (p=ns). The incidence of major adverse cardiac and cerebral events was 0.9% in the TR and 0.8% in the TF group (p=ns). Procedure time (1,620 [1,230-2,100] vs. 1,500 [1,080-2,100] sec, p=ns) and fluoroscopy time (540 [411-735] vs. 501 [378-702] sec, p=ns) were not significantly different, but the radiation dose was significantly higher in the TR group (195 [129-274] vs. 148 [102-237] Gy*cm2, p<0.05) by per-protocol analysis. Hospitalisation days were significantly lower in the TR group (1.17±0.40 vs. 1.25±0.45, p<0.05). By intention-to-treat analysis there was a significantly higher radiation dose in the TR group (195 [130-288] vs. 150 [104-241], p<0.05), but no difference in major events (0.9 vs. 0.8, p=ns) and length of hospitalisation in days (1.4±2.6 vs. 1.25±0.45, p=ns). CONCLUSIONS The transradial approach for carotid artery stenting is safe and efficacious; however, the crossover rate is higher with transradial access. There are no differences in the total procedure duration and fluoroscopy time between the two approaches but the radiation dose is significantly higher in the radial group, and the hospitalisation is shorter with the use of transradial access by per-protocol analysis. By evaluating the patient data according to intention-to-treat analysis we found no difference in major adverse events and hospitalisation. In both groups, vascular complications rarely occurred.
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Affiliation(s)
- Zoltán Ruzsa
- Semmelweis University, Heart and Vascular Center, Budapest, Hungary
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De Luca G, Schaffer A, Wirianta J, Suryapranata H. Comprehensive meta-analysis of radial vs femoral approach in primary angioplasty for STEMI. Int J Cardiol 2013; 168:2070-81. [PMID: 23490083 DOI: 10.1016/j.ijcard.2013.01.161] [Citation(s) in RCA: 47] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/18/2012] [Revised: 11/04/2012] [Accepted: 01/13/2013] [Indexed: 11/25/2022]
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Gellen B, Lesault PF, Canouï-Poitrine F, Champagne S, Mouillet G, Pongas D, Le Thuaut A, Jakljevic T, Boudiche S, de la Vega M, Maalej A, Veugeois A, Dubois-Randé JL, Teiger E. Feasibility limits of transradial primary percutaneous coronary intervention in acute myocardial infarction in the real life (TRAP-AMI). Int J Cardiol 2013; 168:1056-61. [DOI: 10.1016/j.ijcard.2012.10.024] [Citation(s) in RCA: 10] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/13/2011] [Revised: 06/02/2012] [Accepted: 10/28/2012] [Indexed: 11/30/2022]
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Marques N, Faria R, Sousa P, Mimoso J, Brandão V, Gomes V, Jesus I. The impact of direct access to primary angioplasty on reducing the mortality associated with anterior ST-segment elevation myocardial infarction: The experience of the Algarve region of Portugal. REVISTA PORTUGUESA DE CARDIOLOGIA (ENGLISH EDITION) 2012. [DOI: 10.1016/j.repce.2012.08.002] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022] Open
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Marques N, Faria R, Sousa P, Mimoso J, Brandão V, Gomes V, Jesus I. Impacto da via verde coronária e da angioplastia primária na redução da mortalidade associada ao enfarte com elevação do segmento ST anterior. A experiência algarvia. Rev Port Cardiol 2012; 31:647-54. [DOI: 10.1016/j.repc.2012.07.005] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/05/2011] [Accepted: 04/23/2012] [Indexed: 12/22/2022] Open
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Bertrand OF, Bélisle P, Joyal D, Costerousse O, Rao SV, Jolly SS, Meerkin D, Joseph L. Comparison of transradial and femoral approaches for percutaneous coronary interventions: a systematic review and hierarchical Bayesian meta-analysis. Am Heart J 2012; 163:632-48. [PMID: 22520530 DOI: 10.1016/j.ahj.2012.01.015] [Citation(s) in RCA: 192] [Impact Index Per Article: 16.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/21/2011] [Accepted: 01/18/2012] [Indexed: 11/26/2022]
Abstract
BACKGROUND Despite lower risks of access site-related complications with transradial approach (TRA), its clinical benefit for percutaneous coronary intervention (PCI) is uncertain. We conducted a systematic review and meta-analysis of clinical studies comparing TRA and transfemoral approach (TFA) for PCI. METHODS Randomized trials and observational studies (1993-2011) comparing TRA with TFA for PCI with reports of ischemic and bleeding outcomes were included. Crude and adjusted (for age and sex) odds ratios (OR) were estimated by a hierarchical Bayesian random-effects model with prespecified stratification for observational and randomized designs. The primary outcomes were rates of death, combined incidence of death or myocardial infarction, bleeding, and transfusions, early (≤ 30 days) and late after PCI. RESULTS We collected data from 76 studies (15 randomized, 61 observational) involving a total of 761,919 patients. Compared with TFA, TRA was associated with a 78% reduction in bleeding (OR 0.22, 95% credible interval [CrI] 0.16-0.29) and 80% in transfusions (OR 0.20, 95% CrI 0.11-0.32). These findings were consistent in both randomized and observational studies. Early after PCI, there was a 44% reduction of mortality with TRA (OR 0.56, 95% CrI 0.45-0.67), although the effect was mainly due to observational studies (OR 0.52, 95% CrI 0.40-0.63, adjusted OR 0.49 [95% CrI 0.37-0.60]), with an OR of 0.80 (95% CrI 0.49-1.23) in randomized trials. CONCLUSION Our results combining observational and randomized studies show that PCI performed by TRA is associated with substantially less risks of bleeding and transfusions compared with TFA. Benefit on the incidence of death or combined death or myocardial infarction is found in observational studies but remains inconclusive in randomized trials.
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Cohen A, Bertrand OF, Meerkin D. Transradial angioplasty for ST-elevation myocardial infarction. Interv Cardiol 2011. [DOI: 10.2217/ica.11.39] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/21/2022] Open
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Ruzsa Z, Pintér L, Kolvenbach R. Anterograde recanalisation of the radial artery followed by transradial angioplasty. CARDIOVASCULAR REVASCULARIZATION MEDICINE 2010; 11:266.e1-4. [DOI: 10.1016/j.carrev.2010.01.007] [Citation(s) in RCA: 29] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/02/2009] [Revised: 01/08/2010] [Accepted: 01/12/2010] [Indexed: 11/28/2022]
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Transradial approach in patients with ST-elevation myocardial infarction treated with abciximab results in fewer bleeding complications: data from EUROTRANSFER registry. Coron Artery Dis 2010; 21:292-7. [DOI: 10.1097/mca.0b013e32833aa6d1] [Citation(s) in RCA: 31] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/26/2023]
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Fang Y, Yang C, Wang X, Zhou L, Wang H, Zeng C. Feasibility and application of single 5F multipurpose catheter in coronary and peripheral angiography via a transradial approach. Int J Cardiol 2010; 151:182-6. [PMID: 20627341 DOI: 10.1016/j.ijcard.2010.05.014] [Citation(s) in RCA: 10] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/05/2010] [Revised: 05/13/2010] [Accepted: 05/16/2010] [Indexed: 10/19/2022]
Abstract
OBJECTIVE Atherosclerosis is a systemic disease, in which coronary and peripheral angiographies are required to be done at the same time in a large number of patients. To shorten the procedure time, and reduce complications, we tested the feasibility and the safety of using a single 5F multipurpose catheter, via transradial approach, for coronary, cerebral and renal angiographies. METHODS One thousand and ninety-two patients were enrolled in the study. The procedure time, local vessel complications, duration of hospitalization, and costs were evaluated. RESULTS Among 1092 patients, the radial artery puncture was successful in 1081 patients, a successful coronary angiography via the radial artery was done in 1074 patients, and the remaining 18 patients had to be accessed via the femoral artery. Thus, successful angiography rate was 97.7% for the right coronary artery, 95.8% for the left coronary artery, 100% for the right cerebral artery, 95.2% for the left subclavian artery, 96.1% for the left carotid artery and 83.1% for the renal artery. The failures were caused by abnormal curvature of the aortic arch and abnormal origins of the above-mentioned arteries. There were 1460 artery stenosis lesions found in 661 patients and 624 lesions (93.3%) needed stents via the transradial approach. The mean procedure time was 20.9 ± 9.3 min including puncture, angiography and hemostasis time. There were 4.35% complications. No local hematoma, hand ischemia, or cerebral infraction was found in this study. CONCLUSION Angiography using a single 5F multipurpose catheter, via transradial approach, is associated with a short procedure time and a low rate of complications without affecting the angiography success rate.
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Affiliation(s)
- Yuqiang Fang
- Department of Cardiology, Daping Hospital, The Third Military Medical University, Chongqing City, 400042, PR China
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Komócsi A, Vorobcsuk A, Aradi D. Transradial percutaneous coronary intervention in acute myocardial infarction. Interv Med Appl Sci 2010. [DOI: 10.1556/imas.2.2010.2.2] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/19/2022] Open
Abstract
Abstract
Although transradial coronary intervention is widely applied for percutaneous procedures, its safety in the setting of ST-segment elevation myocardial infarction (STEMI) is controversial. The benefit of transradial approach in terms of reducing access site complications is well documented. However, higher rate of procedural failure and longer procedural times reported by some authors raise concerns regarding its applicability in STEMI. Our aim was to review the safety and efficacy of transradial coronary intervention versus transfemoral intervention in acute ST-elevation myocardial infarction. This review focuses on key aspects of safety and efficacy: adverse ischemic and bleeding events, reperfusion times and radiation exposure.
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Affiliation(s)
- András Komócsi
- 1 Heart Institute, Faculty of Medicine, University of Pécs, Pécs, Hungary
- 2 University of Pécs, Heart Institute, H-7624, Pécs, Ifjúság u. 13, Hungary
| | - A. Vorobcsuk
- 1 Heart Institute, Faculty of Medicine, University of Pécs, Pécs, Hungary
| | - D. Aradi
- 1 Heart Institute, Faculty of Medicine, University of Pécs, Pécs, Hungary
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