Comparação da intervenção coronária percutânea por via radial em pacientes com doença arterial coronária estável e instável

Abstract

Background: The transradial approach for percutaneous coronary intervention (PCI) is still not widely used in our country. We evaluated the results of transradial PCI performed at a tertiary hospital, which has progressively incorporated this technique to its daily clinical practice. Methods: This is a retrospective study of patients treated from 2007 to 2012 at Instituto Dante Pazzanese de Cardiologia. Clinical, angiographic and procedural profile and in-hospital outcomes of patients with stable and unstable coronary artery disease (CAD) treated with the transradial approach were compared. Results: We included 2,507 patients, of which 72.6% had stable and 27.4% had unstable CAD. Patients with stable CAD had a more complex clinical profile, characterized by being older, more frequently females, with a higher incidence of comorbidities. The angiographic and procedural characteristics were not different for most of the variables analyzed. The success rate was high, but higher in the stable CAD group (94.6% vs. 92.4%; P = 0.05). The incidence of death (0.2% vs. 0.3%; P = 0.61), periprocedural infarction (4.7% vs. 6.6%; P = 0.07), stroke (0.1% vs. 0.1%; P > 0.99), PCI (0.1% vs. 0.3%; P = 0.30), coronary artery bypass graft (0 vs. 0.4%; P = 0.06), major bleeding (0.2% vs. 0.6%; P = 0.09) or vascular complications (1% vs. 0.6%; P = 0.47) was low and did not differ between groups. Conclusions: Transradial PCI has proved to be safe and effective in patients with stable and unstable CAD, treated at a tertiary hospital that has progressively incorporated this technique to its daily practice.

Analysis of patients submitted to percutaneous coronary intervention via radial artery access. The SAFIRA Registry database

“…A similar result was found in a single center study performed at the Instituto Dante Pazzanese de Cardiologia, in São Paulo, from 2007 to 2012, where 72.6% of patients had stable coronary artery disease and radial access was associated with a reduction in the risk of vascular complications when compared to the femoral access. 13…”

Intervenção coronária percutânea pelas vias radial e femoral: comparação entre desconfortos relacionados ao procedimento e custos

“…4 No Brasil, a utilização do acesso radial para a reali zação de ICP vem apresentando aumento progressivo. 5,6 No entanto, ainda são escassos os estudos a respeito dos desconfortos relacionados ao procedimento e dos custos comparando as duas vias de acesso. 4,7,8 A gestão de custos é um instrumento gerencial fundamental para o controle dos recursos das instituições médicas, públicas ou privadas.…”