Coronary interventions via radial artery without pre procedural routine use of spasmolytic agents
| Autor: | Błażej Kusz, Małgorzata Kowal-Kałamajka, Katarzyna Mizia-Stec, Tomasz Roleder, Tomasz Bochenek, Andrzej Jaklik, Michał Lelek, Jan Szczogiel |
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| Rok vydání: | 2020 |
| Předmět: |
Original Paper
medicine.medical_specialty spasm Percutaneous medicine.diagnostic_test business.industry Ultrasound Psychological intervention occlusion percutaneous Internal medicine medicine.artery Angiography Occlusion medicine Cardiology Medicine Local pressure Via radial artery Radial artery Cardiology and Cardiovascular Medicine business |
| Zdroj: | Postępy w Kardiologii Interwencyjnej = Advances in Interventional Cardiology Advances in Interventional Cardiology, Vol 16, Iss 2, Pp 138-144 (2020) |
| ISSN: | 1734-9338 |
| DOI: | 10.5114/aic.2020.96056 |
| Popis: | Introduction Radial access reduces the number of vascular complications. Radial artery spasm (RAS) can be prevented by the use of spasmolytic agents. However, use of these drugs can be possibly limited to certain groups of patients. Aim To assess the feasibility and safety of coronary angiography and percutaneous coronary interventions through the radial artery without the routine use of spasmolytic agents. Material and methods A group of 293 patients (M/F 180/113, mean age: 67 ±10 years) who underwent coronary angiography and interventions through the radial artery approach was studied. Spasmolytic agents were applied in case of RAS. Every patient had ultrasound assessment of the radial artery on the next day to assess its diameter and detect occlusion. Results RAS was observed in 55 patients (18.8%, M/F 28/27) and radial artery occlusion (RAO) in 47 (16%, M/F: 24/23) cases. RAS was followed by RAO in 17 cases, which constituted 17/55 (30.9%) of all RAS. Two patients had symptomatic occlusion, which required prolonged anticoagulation with complete restoration of patency. The RAS was higher in prolonged procedures (angiography time 32.6 ±12.8 vs. 29 ±13.5 min, p = 0.03; intervention time 40 ±23.5 vs. 26.3 ±25 min, p = 0.0035) and was dependent on time of the local pressure (7.5 ±2.3 vs. 6.5 ±2.8 h, p = 0.03). The RAO increased proportionally to the number of catheters used (p = 0.01) and was dependent on time of the local pressure (8.6 ±3.5 vs. 6.4 ±2.7 h, p < 0.001). Conclusions Our study showed that angiography and interventions without routine use of spasmolytic agents were feasible and safe. RAS and RAO are related to independent risk factors and comparable to data from the literature when spasmolytics were used. |
| Databáze: | OpenAIRE |
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