SUMMARY Coronary Angiography: Transbrachial Technique RevisitedObjectives: To report the experience using the transbrachial approach for coronary angiography. Methods: 106 patients were studied with possible diagnosis of coronary artery disease using transbrachial catheterization. A preselected catheter (MP2) was introduced through a 5 F sheath and left heart catheterization and angiography performed in the usual manner. At the end of the procedure, the sheath was removed and hemostasis accomplished by manual compression. Results: Most procedures (76.4%) were performed with a single catheter (MP2). The median fluoroscopy time was 4.5 min. In only 4 cases, during the learning curve of one operator, a different technique had to be performed. Three patients suffered small hematomas, 4 patients presented with small and 6 with moderate ecchymosis; there were no severe complications. Conclusions: The transbrachial technique is effective and safe; it has facilitated outpatient catheterization with a low rate of complications. DESCRIPTORS:Heart catheterization, methods. Coronary angiography. Brachial artery. RESUMOObjetivo: Demonstrar a experiência na execução da técnica de punção braquial para a realização de coronariografia. Método: Foram avaliados 106 pacientes ambulatoriais com suspeita de doença coronária submetidos a coronariografia pela técnica transbraquial. Foi pré-selecionado cateter MP2 introduzido através de bainha 5F, e o cateterismo esquerdo e angiografia realizados da maneira usual. Ao término do exame, foi retirada a bainha e a hemostasia realizada por compressão manual. Resultados: A maioria dos exames (76,4%) foi completada com a utilização de um único cateter (MP2). A mediana do tempo de fluoroscopia foi 4,5 min. Em apenas 4 casos a técnica teve que ser substituída, todas ocorreram com um mesmo operador durante a curva de aprendizagem. Observamos a presença de hematoma de pequeno volume em 3 pacientes, logo após o procedimento, áreas discretas de equimose em 4 e equimoses mais extensas em 6 doentes, não tendo ocorrido complicações graves. Conclusões: A técnica transbraquial mostrouse efetiva e segura, facilitando a realização de cateterismo ambulatorial com baixa freqüência de complicações.
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