Related Experiment Video
Updated: Jul 24, 2026
A Rat Carotid Artery Pressure-Controlled Segmental Balloon Injury with Periadventitial Therapeutic Application
Published on: July 9, 2020
Efficacy and safety of PTCA using brachial approach and low-dose heparin
H Taguchi1, T Kawarabayashi, A Tanaka
1Department of Cardiology, Baba Memorial Hospital, Sakai, Japan.
Insights
Percutaneous transluminal coronary angioplasty (PTCA) via the brachial approach with low-dose heparin is safe and effective. This method may reduce vascular complications compared to the standard femoral approach, offering a viable alternative for specific patient groups.
Area of Science:
- Cardiology
- Interventional Cardiology
- Vascular Medicine
Background:
- Percutaneous transluminal coronary angioplasty (PTCA) commonly uses the femoral artery approach.
- The brachial approach is an alternative for patients with peripheral artery disease or those requiring shorter recovery.
- Concerns exist regarding higher vascular complication rates with brachial PTCA, potentially linked to higher heparin doses.
Purpose of the Study:
- To evaluate the efficacy and safety of brachial-approach PTCA using a low-dose heparin strategy.
- To test the hypothesis that reduced heparin dosage mitigates vascular complications in brachial PTCA.
- To compare outcomes of brachial-approach PTCA with low-dose heparin against standard femoral-approach PTCA.
Main Methods:
- A comparative study involving patients undergoing PTCA for angina pectoris.
- 217 patients (221 lesions) underwent brachial-approach PTCA with low-dose heparin.
- 102 patients (115 lesions) underwent femoral-approach PTCA with standard heparin, serving as the control group.
- Vascular complications and use of anodynes were monitored in both groups.
Main Results:
- No significant differences in patient or lesion characteristics were observed between the groups.
- Vascular complication incidence was numerically lower in the brachial group (1.8%) versus the femoral group (3.5%), though not statistically significant.
- Anodyne use was significantly lower in the brachial approach group (3.6%) compared to the femoral group (33%).
Conclusions:
- Brachial-approach PTCA with low-dose heparin is a safe and effective strategy.
- This approach appears comparable to the standard femoral approach in terms of safety and efficacy.
- The findings suggest that optimizing heparin dosage may reduce complications associated with the brachial approach for PTCA.
Abstract:
Percutaneous transluminal coronary angioplasty (PTCA) is routinely performed using the femoral approach. However, recent reports suggest the usefulness of the brachial approaches for patients for whom the femoral approach is impossible due to peripheral vessel disease or to shortened postoperative rest times. However, some reports have revealed that the incidence of vascular complications undergoing brachial-approach PTCA may be higher than those with the femoral approach, possibly due to relatively higher dose of heparin. Accordingly, in this study we evaluated the efficacy and safety of PTCA using the brachial approach and low-dose heparin, hypothesizing that lowering the heparin dose might result in reduced vascular complications. The study population of patients admitted for angina pectoris consisted of 217 subjects (221 lesions) who underwent brachial-approach PTCA and 102 subjects (115 lesions) who underwent PTCA via the femoral approach. Both groups were monitored for complications. There were no significant differences in patient or lesion characteristics between the groups. Incidence of vascular complications tended to be lower in the brachial group than in the femoral group (1.8% vs. 3.5%), although the difference did not reach statistical significance. Use of anodynes was also significantly lower in the brachial group (3.6% vs. 33%). PTCA from the brachial approach with low-dose heparin is as safe and effective a strategy as compared with the femoral approach with standard dose of heparin.
More Related Videos
10:28Interventional Diagnostic Procedure: A Practical Guide for the Assessment of Coronary Vascular Function
Published on: March 15, 2022
13:48Reduction of Radiation Exposure during Endovascular Treatment of Peripheral Arterial Disease Combining Fiber Optic RealShape Technology and Intravascular Ultrasound
Published on: April 21, 2023
Related Concept Videos
01:30Anticoagulant Drugs: Low-Molecular-Weight Heparins
01:26Treatment for Pulmonary Arterial Hypertension: Receptor Tyrosine Kinase Inhibitors and Calcium Channel Blockers
TKIs, such as imatinib (Gleevec), are particularly effective in tackling the growth and mitogenic factors that become upregulated in PAH patients. These factors contribute to the...
01:27Coronary Artery Disease V: Interprofessional Care
01:27Peripheral Artery Disease III: Interprofessional Care
01:29Venous Thrombosis III: Interprofessional Care