Impact of sheath size and hemostasis time on radial artery patency after transradial coronary angiography and intervention in Japanese and non-Japanese patients: A substudy from RAP and BEAT (Radial Artery Patency and Bleeding, Efficacy, Adverse evenT) randomized multicenter trial.

Autor: Aminian A; Centre Hospitalier Universitaire de Charleroi, Charleroi, Belgium., Saito S; Shonan Kamakura General Hospital, Kanagawa, Japan., Takahashi A; Sakurakai Takahashi Hospital, Kobe, Japan., Bernat I; University Hospital and Faculty of Medicine Pilsen, Pilsen, Czech Republic., Jobe RL; UNC Rex Healthcare, Raleigh, North Carolina., Kajiya T; Tenyoukai Central Hospital, Kagoshima, Japan., Gilchrist IC; Pennsylvania State University, Heart & Vascular Institute, Hershey, Pennsylvania., Louvard Y; Institut Hospitalier Jacques Cartier, Massy, France., Kiemeneij F; Tergooi Hospital, Blaricum, The Netherlands.; MC Zuiderzee, Lelystad, The Netherlands., van Royen N; VU University Medical Center, Amsterdam, The Netherlands., van Leeuwen M; VU University Medical Center, Amsterdam, The Netherlands.; Isala Heart Center, Zwolle, The Netherlands., Yamazaki S; Sapporo Higashi Tokushukai Hospital, Hokkaido, Japan., Matsukage T; Tokai University School of Medicine, Isehara, Japan., Iglesias JF; Geneva University Hospital, Geneva, Switzerland., Rao SV; The Duke Clinical Research Institute, Durham, North Carolina.
Jazyk: angličtina
Zdroj: Catheterization and cardiovascular interventions : official journal of the Society for Cardiac Angiography & Interventions [Catheter Cardiovasc Interv] 2018 Nov 01; Vol. 92 (5), pp. 844-851. Date of Electronic Publication: 2018 Feb 16.
DOI: 10.1002/ccd.27526
Abstrakt: Background: During transradial (TR) access, it remains unclear whether differences in baseline patients characteristics and hemostasis care impact the rate of radial artery occlusion (RAO). We sought to compare the rate of RAO after TR access with the 6 French(Fr) Glidesheath Slender (GSS6Fr, Terumo, Japan) or a standard 5 Fr sheath in Japanese and non-Japanese patients.
Methods and Results: The Radial Artery Patency and Bleeding, Efficacy, Adverse evenT (RAP and BEAT) trial randomized 1,836 patients undergoing TR coronary angiography and/or interventions to receive the GSS6Fr or the standard 5 Fr Glidesheath (GS5Fr, Terumo, Japan). Out of this study population, 1,087 were Japanese patients and 751 non-Japanese patients. The overall incidence of RAO was significantly higher in Japanese patients (3.6% vs. 1.2%, P = 0.002). Use of GSS6Fr was associated with higher rates of RAO than GS5Fr in Japanese patients (5% vs. 2.2%, P = 0.02) and with similar RAO rates in non-Japanese patients (1.3 vs. 1.1%, P = 1). The mean hemostasis time was significantly longer in Japanese patients (378 ± 253 vs. 159 ± 136 min, P < 0.001) and more Japanese patients had a hemostasis time of more than 6 hr (16.2% vs. 4.9%, P < 0.0001). Longer hemostasis time was an independent predictor of RAO (OR per additional hour 1.070, 95% CI 1.008-1.136, P = 0.03).
Conclusions: Use of GSS6Fr was associated with a higher rate of RAO than a standard 5 Fr sheath in Japanese patients but not in non-Japanese patients. Whether improvement in post-procedural care and reduced hemostasis time could impact the incidence of RAO in Japanese patients should be further assessed.
(© 2018 The Authors Catheterization and Cardiovascular Interventions Published by Wiley Periodicals, Inc.)
Databáze: MEDLINE
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