Utilização do acesso radial elimina a ocorrência de sangramento grave relacionado ao sítio de punção após intervenção coronária percutânea primária

Andrade, Pedro Beraldo de; Tebet, Marden André; Silva, Felipe Souza Maia da; Andrade, Mônica Vieira Athanazio de; Mattos, Luiz Alberto; Labrunie, André

doi:10.1590/s2179-83972010000400006

Cited by 17 publications

(10 citation statements)

References 21 publications

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“…In this study, the need to change approa ches occurred in less than 3% of the cases and no excessive durations or increased material usage were observed, which reflects the importance of experience and familiarity with the procedure to the final results. [16][17][18] Similar findings were reported in a recent subanalysis of the Harmonizing Outcomes with Revascularization and Stents (HORIZONS-AMI) study, in which, compared to the femoral approach, the radial approach was associated with lower rates of severe bleeding, reinfarction, and 30-day and 1-year mortality, with similar procedure durations, fluoroscopy times, and door-balloon times. 19 Therefore, the radial technique represents a complementary strategy to reduce haemorrhagic complications in the elderly when combined with the following: judicious choice of anti-thrombotic therapy using the minimum effective dose and promoting adjustments when needed; administration of medication in the shortest time possible; and the attempt to achieve fine equilibrium between safety and efficacy.…”

Section: Discussionsupporting

confidence: 80%

Impacto da utilização do acesso radial na ocorrência de sangramento grave entre idosos submetidos a intervenção coronária percutânea

Andrade¹,

Tebet²,

Andrade³

et al. 2012

Rev. Bras. Cardiol. Invasiva

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Background: The development of major bleeding after percutaneous coronary intervention (PCI) is associated with higher morbidity and mortality, and advanced age is one of its main predictors. This analysis aimed to evaluate the impact of the use of the transradial approach on the incidence of bleeding complications in elderly patients undergoing PCI. Methods: This was a consecutive and controlled registry of patients ≥ 60 years of age undergoing PCI by the transradial approach. Angiographic procedure success, technical failure, and the incidence of ischaemic adverse events and major bleeding were evaluated. Results: Between May of 2008 and December of 2010, 707 elderly patients underwent PCI; in 635 patients (89.8%), the transradial approach was used. The mean age was 69.9 ± 7.2 years, and 11.5% were > 80 years of age. 39.7% of the patients female, and 30.9% had diabetes mellitus. Acute ischaemic syndrome accounted for 72% of the clinical indications. The angiographic success rate was 96.8%, with a crossover rate of 2.8%. The in-hospital mortality rate was 2.4%: myocardial infarction occurred in 0.9%, stroke occurred in 0.3%, and stent thrombosis occurred in 0.9%. Hematomas were reported in 1.6% of the procedures, with a major bleeding rate of 0.8%. Conclusions: In elderly patients undergoing PCI, representative of contemporary practice and with high risk of bleeding, the use of the transradial approach, was associated with a low major bleeding rate.

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Section: Discussionsupporting

confidence: 80%

Impacto da utilização do acesso radial na ocorrência de sangramento grave entre idosos submetidos a intervenção coronária percutânea

Andrade¹,

Tebet²,

Andrade³

et al. 2012

Rev. Bras. Cardiol. Invasiva

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“…16 The Acute Catheterisation and Urgent Intervention Triage strategY (ACUITY) study has demonstrated that the transradial approach reduces the rate of major bleeding compared to femoral access in patients with acute coronary syndromes (3% vs. 8.4%; P = 0.03). 17 Finally, in Brazil, Andrade et al 18 published a study with consecutive patients who underwent primary PCI through radial access and demonstrated that the performance of this procedure by experienced surgeons is safe, with a virtual absence of severe vascular complications related to the puncture site, findings that were reproduced in our study.…”

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confidence: 73%

Intervenção coronária percutânea por acesso transradial em pacientes com infarto agudo do miocárdio com supradesnivelamento do segmento ST

Dall'Orto¹,

Lopes²,

Oliveira³

et al. 2012

Rev. Bras. Cardiol. Invasiva

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background: Radial access is the object of increasing interest for interventional cardiologists, providing several advantages, including the reduced rates of major bleeding, which is related to increased risk of death and ischemic events. However, its role as an access technique in primary percutaneous coronary intervention (PCI) remains controversial due to the greater complexity of the procedure and possible delay in obtaining myocardial reperfusion, compared to femoral access. Methods: Retrospective study including consecutive patients with a diagnosis of ST-elevation acute myocardial infarction (STEMI) undergoing primary PCI by radial access. Clinical, angiographic and procedure characteristics were analyzed, as well as early and late follow-up outcomes. results: From October 2010 to February 2012, 61 patients underwent primary PCI by radial access. Mean age was 59 ± 11.1 years, 24.6% were female and 21.3% were diabetic. Door-to-balloon time was 126.1 ± 44.7 minutes, fluoroscopy time was 16.1 ± 9.5 minutes, angiographic success was achieved in 98.5%, with myocardial blush grades 2 and 3 in 77.4% and ST-segment elevation resolution > 50% at 90 minutes in 70.5% of the patients. Hospital mortality was 6.6% and the rate of major bleeding was 1.6%. In the late follow-up, clinical restenosis was observed in 7.2% and additional deaths in 3.5% of the patients. Conclusions: The use of radial access for primary PCI is safe and effective when performed at experienced centers and did not pres-

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“…11 Esses resultados foram encontrados apenas entre os operadores com maior experiência no acesso radial (400 casos/ano). Em nosso meio, publicações de Andrade et al 12 e do nosso grupo 13 reproduziram os benefícios da opção pelo acesso radial na ICP primária.…”

Section: Discussionunclassified

Comparação dos Resultados da Intervenção Coronária Percutânea por Via Radial na Síndrome Coronariana Aguda Entre Mulheres e Homens

Dall'Orto¹,

Lopes²,

Filho³

et al. 2014

Rev. Bras. Cardiol. Invasiva

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Utilização do acesso radial elimina a ocorrência de sangramento grave relacionado ao sítio de punção após intervenção coronária percutânea primária

Cited by 17 publications

References 21 publications

Impacto da utilização do acesso radial na ocorrência de sangramento grave entre idosos submetidos a intervenção coronária percutânea

Impacto da utilização do acesso radial na ocorrência de sangramento grave entre idosos submetidos a intervenção coronária percutânea

Intervenção coronária percutânea por acesso transradial em pacientes com infarto agudo do miocárdio com supradesnivelamento do segmento ST

Comparação dos Resultados da Intervenção Coronária Percutânea por Via Radial na Síndrome Coronariana Aguda Entre Mulheres e Homens

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