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Transradial approach for coronary interventions
J C Brito1, A Azevedo, A Oliveira
1Rua Wanderley de Pinho 305/302 - 41841-300, Salvador, BA Brazil.
Insights
Percutaneous coronary interventions via the radial artery are feasible and safe. This approach demonstrated a high success rate with a low incidence of complications in 103 patients undergoing coronary procedures.
Area of Science:
- Cardiovascular Medicine
- Interventional Cardiology
- Vascular Access
Background:
- Transradial access is an alternative to transfemoral access for coronary procedures.
- Assessing the safety and efficacy of radial artery access is crucial for interventional cardiology.
Purpose of the Study:
- To evaluate the feasibility and safety of performing coronary interventions using the radial artery.
- To determine the complication rates associated with transradial percutaneous coronary interventions.
Main Methods:
- A study of 103 patients (87% male, age 38-86) undergoing coronary interventions.
- Inclusion criteria included adequate radial pulse, ulnar pulse, and good collateral flow (Allen's test).
- Procedures included angioplasty and stenting of various coronary arteries and bypass grafts.
Main Results:
- Vascular access was successful in 94% of patients.
- Coronary interventions were performed for diverse indications including acute myocardial infarction, unstable and stable angina.
- High success rates were achieved: 100% for stent deployment and 96% for balloon angioplasty, with low complication rates (1% MI, 2% hematoma, 2% pulse loss).
Conclusions:
- The radial artery approach is a practical and safe method for percutaneous coronary interventions.
- Transradial access offers a low complication profile, making it a viable option for coronary procedures.
Objective:
To assess the feasibility and safety of coronary interventions performed through the radial artery.
Methods:
We studied 103 patients with ages from 38 to 86 years (57+/-8.7), 90 (87%) males, and: radial pulse with a good amplitude, presence of ulnar pulse, a good collateral flow through the palmar arch assessed with the Allen's test.
Results:
The vascular approach was obtained in 97 (94%) patients, 88 (91%) treated electively and 9 (9%) during acute myocardial infarction, for primary angioplasty; 56 (64%) unstable angina; 22 (25%) stable angina; 10 (11%) were asymptomatic, 6 referred for recanalization of chronic occlusion and 4 silent ischemia in the first week after acute myocardial infarction. We approached 107 arteries: anterior descending artery, 49 (46%); right coronary artery, 27 (25%); circumflex artery, 25 (23%); diagonal artery, 6 (6%); and 2 saphenous vein bypass grafts. We treated 129 lesions: 80 (62%) B2 type; 23 (18%) B1 type; 17 (13%) C type; and 9 (7%). A type. There were 70 stents, and 59 balloon angioplasties performed. Thirty-two (33%) patients used GP IIb/IIIa inhibitors. The mean duration of the elective procedure was 42.3+/-12.8 min. Success, correct stent deployment and residual lesion <20%, was reached in 100% of the lesions treated with stent implantation; arterial dilation with residual lesion <50% was obtained in 96% of the lesions treated with transluminal coronary angioplasty (TCA). Complications, were: 1 (1.0%) non-Q-wave acute myocardial infarction; 2 (2%) hematomas in the forearm; and 2 losses of radial pulse.
Conclusion:
Radial artery approach is practical and safe for percutaneous coronary interventions there was a low incidence of complications.