Background: The distal transradial approach (dTRA) is anticipated to improve the benefits of transradial availability, hemorrhagic incidents and the occurrence of radial artery occlusion (RAO) with the dTRA is uncertain. The aim of this study to investigate the puncture time rate, homeostasis and radial artery occlusion related to low BMI in distal artery access (dTRA) vs conventional radial artery access (cTRA). Study design: This cross-sectional study was carried out at NICVD, Nawabshah, for the duration of six months from July 2022 to December 2022. Materials and Methods: The total participants were 160 who diagnosed coronary artery disorder and include 75 participants in dTRA and 85 participants in cTRA. The age group were included >21 years. The demographic data, surgical methods, catheterization, procedure-related data, procedures of puncture, ultrasound follow up and BMI were recorded. All data was analyzed by SPSS 22 version. Results: The mean age of participants in dTRA group was 72.0±10.1 years and cTRA group was 73.0±18.0 years. In gender, age and BMI were non-significant in both groups. The crossover rate, puncture time, one needle puncture rate and radial artery occlusion were shown significantly change in dTRA and cTRA group, p=0.005. Conclusion: Distal radial access is a new facility for cardiovascular interventions that provides several benefits over prior links. The key benefits would be less arterial blockage and faster hemostasis. When compared to traditional radial artery access, the dTRA may be a viable and reliable connectivity site for both diagnostic and interventional coronary methods, with a decreased prevalence of RAO, high crossover rate and time needed for hemostasis. Keywords: Distal transradial artery (dTRA); conventional transradial artery (cTRA); Radial artery occlusion (RAO)
Background: The insufficient supply oxygen and blood to the myocardium is characterized by the coronary artery disease. The coronary arteries occlusion leads to this condition. The plaques formation in coronary arteries lumen is indicative of the condition. These plaques impede blood flow. It is a major concern worldwide. Objective: To evaluate the mortality frequency in cardiogenic shock in anterior wall myocardial infarction in patients presenting to Lady Reading Hospital, Peshawar. Study Design: It is a descriptive case study conducted at department of Cardiology, Lady Reading Hospital Peshawar and NICVD, Nawabshah. This study was conducted from 1st June 2021 to 30th November 2021. Subjects and Methods: A total of 139 patients diagnosed with cardiogenic shock were selected for the study. According to the operational definition the followed up of all patients till discharge and mortality was recorded. Results: The age range of the patients selected for the study was 18-70 years. The mean of age was 47.841±6.66 years, mean weight 83.259±7.39 Kg and mean duration of symptoms was 8.870±3.76 hours. Male patients were 77.7% and females were 22.3%. Mortality was seen in 20.9% patients. Conclusion: Patients with anterior wall myocardial infarction and cardiogenic shock undergoing percutaneous coronary intervention have better clinical out-comes. The decreased mortality is also observed. Without the delay of time the patients must be transferred to the primary percutaneous coronary intervention facility if it is far away. There is need to establish more primary percutaneous coronary intervention centers. Keywords: Anterior wall myocardial infarction, cardiogenic shock, mortality.
Introduction: It is not clear whether patients receiving oral anticoagulants (OC) during surgery involving access to the common femoral artery would experience more adverse effects than those not receiving OC. In this analysis, we determine whether patients receiving oral anticoagulants undergoing cardiac catheterization are at high risk of complications related to femoral site than subjects not receiving OACs. Study Settings: This study was held in the Cardiology department of Qazi Hussain Ahmed Medical Complex, Nowshera and Peoples University of Medical and Health Sciences for Women PUMHSW (SBA) Nawabshah for one-year duration from January 2021 to December 2021. Methods: A total of 300 patients were selected for the study. We regularly reviewed data from patients undergoing cardiac surgery at the same tertiary care center. A patient was classified as fully or partially anti-coagulated (Group A) if his international normalized ratio (INR) was greater than 1.6 on the surgery day or if he received new OAC or warfarin within 48 hours or less after surgery. The group without anticoagulants (Group B) had an INR of 1.6 or had stopped the new OAC and warfarin more than 48 and 24 hours prior to surgery, respectively. Results: A total of 300 patients (mean age 65.6±12.2, 60% male) were registered in the study. 20 (6.7%) were in Group A and Group B included 280(93.3%) patients. The intervention was done among 162/300 (54%) patients and received treatment with Intra-procedural anticoagulation with heparin (50.0%), bivalirudin (23.3%) or both (3.3%). GpIIb/IIIa inhibitors were used infrequently (1%). Conclusions: Compared to patients who did not receive anticoagulants during the procedure, OAC patients experienced no major serious adverse events after 30 days. Keywords: Oral anticoagulant, Common femoral artery, complications, access site.
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