Abstract:
BACKGROUND:The transradial approach for coronary procedures is associated with a low complication rate, but specific training is considered mandatory. METHODS:Procedural characteristics (contrast dye: CD; fluoroscopy time: FT, patient radiation dose: RD) and local complication rates were prospectively assessed in 784 consecutive patients who underwent transradial coronary procedures. The study was divided into an implementation (2008-IP) and an evaluation period (2009-EP). Transradial (N = 624) and transfemoral (N = 842) procedural characteristics were compared in the EP. RESULTS:The amount of CD (mL) of transradial coronary angiography was similar between IP (75 [IQR 60-100]) and EP (70 [55-100]; P = 0.630). In contrast, FT (min) of transradial coronary angiography could be reduced from IP (4.4 [3.2-6.8]) to EP (4.1 [2.7-6.5]; P = 0.036), whereas RD (μGy * qcm) was similar (IP: 1623 [1042-3026]); EP (1576 [944-2530]; P = 0.149). Safety data showed a low complication rate: 0.2% access failure, 0.1% dissection, 0.7% vessel closure. Transfemoral procedures were followed by significantly more procedure- related transfusions (1.3% vs. 0%; P = 0.003). The comparison between transfemoral and transradial procedures demonstrated prolonged FT for transradial procedures (transfemoral 2.9 [1.7-5.5]; transradial 4.1 [2.7-6.5]; P = 0.002), whereas CD was similar (transfemoral 70 [55-100]; transradial 70 [55-100]; P = 0.248). The prolonged FT was restricted to coronary angiography but did not differ for PCI (transfemoral 9.7 [5.8-18.1]; transradial 8.9 [5.3-16.5]; P = 0.433). CONCLUSION:A transradial program can be implemented with safety; therefore, the transradial approach should be preferred in suitable patients. Since spasm occurrence was the major determinant of procedural failure, further effort is need to develop better strategies for spasm prevention.
journal_name
J Interv Cardioljournal_title
Journal of interventional cardiologyauthors
Lehmann R,Ehrlich JR,Weber V,de Rosa S,Gotarda MN,Schächinger V,Zeiher AM,Fichtlscherer Sdoi
10.1111/j.1540-8183.2010.00603.xsubject
Has Abstractpub_date
2011-02-01 00:00:00pages
56-64issue
1eissn
0896-4327issn
1540-8183journal_volume
24pub_type
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pub_type: 杂志文章
doi:10.1111/joic.12033
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pub_type: 杂志文章,评审
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更新日期:2002-12-01 00:00:00
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doi:10.1111/j.1540-8183.2008.00354.x
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journal_title:Journal of interventional cardiology
pub_type: 杂志文章,多中心研究,随机对照试验
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journal_title:Journal of interventional cardiology
pub_type: 杂志文章,meta分析
doi:10.1111/joic.12551
更新日期:2018-12-01 00:00:00
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