Intervenção coronária percutânea pela via radial: incorporação da técnica e resultados de um centro de formação em cardiologia intervencionista

Abstract

background:The radial artery access has evolved into a flexi ble approach in the last decade, showing similar or superior results when compared to the femoral approach. We assessed the incorporation of the radial artery access in a training center for interventional cardiologists and compared the results to those of the femoral artery access. Methods: Observational, singlecenter study, including consecutive patients undergoing percutaneous coronary intervention (PCI) between 2007 and 2011. The access route was chosen by the resident along with the interventionist responsible for PCI. We compared the composite endpoint of death, periprocedural myocardial infarction (MI), ischemic stroke or major bleeding between the two groups during hospitalization. Results: Among 5,545 patients undergoing PCI, 29.8% used the radial approach and 70.2 used the femoral approach. Mean age was 60.8 ± 11.7 years, 68.9% were males and 29% had acute coronary syndromes. There was an increase in the use of the radial approach until 2010 and stabilization in the subsequent year (11.8% in 2008, 26.2% in 2009, 45.1% in 2010 and 42.6% in 2011). Patients using the radial approach had a less complex clinical and angiographic profile. There were no differences in the composite endpoint (5% vs. 5.9%; P = 0.18), death

Complicações da intervenção coronária percutânea: inferência dos diagnósticos de enfermagem

“…Outro trabalho, no qual foi realizada análise retrospectiva de 2.027 pacientes consecutivos submetidos à intervenção coronária percutânea eletiva, a via radial foi realizada em 27% dos pacientes, dos quais 45,1% apresentavam lesões uniarteriais (45,1% vs. 37,3%; P < 0,001), apresentaram maior sucesso (99% vs. 97,3%; P = 0,046), menor número de eventos cardíacos adversos maiores nas fases tanto hospitalar (0,7% vs. 2%; P = 0,043) como tardia (11,3% vs. 16,3%; P < 0,005) em relação a via femoral [16].…”

Primary Angioplasty in the ACCEPT Registry: Why has it Been Difficult to Accept and Implement the Radial Artery Access as Preferential?

“…Of all the challenges identified, the need for a higher learning curve to achieve proficiency with the radial procedures is the most important. In recent years, a significant increase has been reported in teaching and incorporation of that technique in training centers of interventional cardiologists 23 , 24 . The radial access requires greater dedication and commitment, which should never be a drawback when additional clinical benefits are aimed at for our patients.…”