Transradial Approach for Left Ventricular Endomyocardial Biopsy.

Autor: Choudhury T; Interventional Cardiology Laboratories, London Health Sciences Centre, London, Ontario, Canada., Schäufele TG; Department of Cardiology, Robert-Bosch-Krankenhaus, Stuttgart, Germany., Lavi S; Interventional Cardiology Laboratories, London Health Sciences Centre, London, Ontario, Canada., Makino K; Mie Prefectural General Medical Center, Yokkaichi, Japan., Nobre Menezes M; Cardiology Department, Santa Maria University Hospital (CHLN), Lisbon Academic Medical Centre, and CCUL, Faculdade de Medicina, Universidade de Lisboa, Lisbon, Portugal., Solomonica A; Interventional Cardiology Laboratories, London Health Sciences Centre, London, Ontario, Canada., Bertrand OF; Québec Heart & Lung Institute, Laval University, Québec, Québec, Canada., Gilchrist IC; Pennsylvania State University, College of Medicine, Heart & Vascular Institute, Hershey, Pennsylvania, USA., Mamas MA; Keele Cardiovascular Research Group, Keele University, Stoke-on-Trent, United Kingdom., Bagur R; Interventional Cardiology Laboratories, London Health Sciences Centre, London, Ontario, Canada; Keele Cardiovascular Research Group, Keele University, Stoke-on-Trent, United Kingdom. Electronic address: rodrigobagur@yahoo.com.
Jazyk: angličtina
Zdroj: The Canadian journal of cardiology [Can J Cardiol] 2018 Oct; Vol. 34 (10), pp. 1283-1288. Date of Electronic Publication: 2018 Aug 02.
DOI: 10.1016/j.cjca.2018.05.007
Abstrakt: Background: Left ventricular endomyocardial biopsy (LV-EMB) may offer a superior diagnostic yield compared with right ventricular endomyocardial biopsy (RV-EMB) in conditions predominantly affecting the LV but is underused compared with RV-EMB. Despite the steep uptake of radial approach in coronary interventions, LV-EMB is usually performed via the femoral artery in contemporary practice. Therefore, the aim of this study was to assess the safety and feasibility of LV-EMB via a transradial approach in a multicentre registry.
Methods: One-hundred and two patients who underwent LV-EMB via transradial approach were included. Clinical characteristics, procedural, safety and feasibility data were evaluated.
Results: LV-EMB was successfully performed via transradial access in 101 (99%) patients. Mild or moderate radial artery spasm occurred in 12 (12%) patients, but only 1 (0.98%) patient required conversion to femoral access due to severe spasm. A total of 80 (78%) patients had LV-EMB via a sheathless guide catheter. Among those, 77 (96.3%) patients had 7.5-French sheathless guides, and 3 (3.8%) patients had 8.5-French sheathless guides inserted. Radial sheaths were used in the remaining 22 patients, with 5-French sheaths in 21 of 22 patients. Heparin was administered to 93.1% of patients at a median dose of 5000 (3000-5000) IU. The remaining patients followed a provisional strategy upon patent hemostasis achievement. No access site-related complications were reported. There were no major complications (pericardial tamponade, life-threatening arrhythmia, cerebrovascular accident or death).
Conclusions: In a population of patients undergoing transradial LV-EMB, the procedural success rate was high and showed an excellent safety profile. Further studies comparing transradial and transfemoral routes may help expand the use of transradial access for LV-EMB.
(Copyright © 2018 Canadian Cardiovascular Society. Published by Elsevier Inc. All rights reserved.)
Databáze: MEDLINE
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