Femoral Versus Radial Access in Primary Angioplasty. Analysis of the ACCEPT Registry

Andrade, Pedro Beraldo de; Andrade, Mônica Vieira Athanazio de; Barbosa, Robson Alves; Labrunie, André; Hernandes, Mauro Esteves; Marino, Roberto Luiz; Précoma, Dalton Bertolim; Sá, Francisco Carleial Feijó de; Berwanger, Otávio; Mattos, Luiz Alberto

doi:10.5935/abc.20140063

Cited by 6 publications

(6 citation statements)

References 15 publications

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“…Vascular events stand out among the most frequent complications, such as bleeding at the insertion site, hematoma, pseudoaneurysm, arterial thrombosis, and distal embolization 4 - 7 . …”

Section: Introductionmentioning

confidence: 99%

Vascular complications in patients who underwent endovascular cardiac procedures: multicenter cohort study

Paganin

Beghetto

Feijó

et al. 2018

Rev. Latino-Am. Enfermagem

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Objective:to analyze vascular complications among patients who underwent endovascular cardiac procedures in the hemodynamic laboratories of three referral centers. Method:a multicenter cohort study was conducted in three referral facilities. The sample was composed of 2,696 adult patients who had undergone elective or urgent percutaneous cardiac procedures. The outcomes were vascular complications, such as: hematoma at the site of the arterial puncture; major or minor bleeding; surgical correction for retroperitoneal hemorrhage; pseudoaneurysm; and arteriovenous fistula. Results:237 (8.8%) of the 2,696 patients presented a vascular complication at the site of the arterial puncture. The total number of vascular complications was 264: minor hematoma<10cm (n=135); stable bleeding (n=86); major hematoma ≥10cm (n=32); and unstable bleeding (n=11). There were no retroperitoneal hematoma events, pseudoaneurysm or arterial venous fistula. Most of the major and minor complications occurred in the first six hours after the procedure. Conclusion:the results concerning the current context of interventional cardiology indicate that the complications predominantly occur in the first six hours after the procedure, considering a 48-hour follow-up. The staff should plan and implement preventive measures immediately after the procedures.

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“…Vascular events stand out among the most frequent complications, such as bleeding at the insertion site, hematoma, pseudoaneurysm, arterial thrombosis, and distal embolization 4 - 7 . …”

Section: Introductionmentioning

confidence: 99%

Vascular complications in patients who underwent endovascular cardiac procedures: multicenter cohort study

Paganin

Beghetto

Feijó

et al. 2018

Rev. Latino-Am. Enfermagem

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“…The success of the procedure occurred in 98.5% of the submitted sample, concluding for the safety of discharge the same day for low-risk patients, both clinical and angiographic, who underwent elective PCI and who progressed without complications associated with the procedure. 32 This study reveals that complications of vascular access and contrast nephropathy, when present, contribute to prolonged hospitalization. However, the development of interventional cardiology, the improvement of techniques and medications, and the tendency for elective PCI to progress to a shorter hospital stay.…”

Section: Methods Introductionmentioning

confidence: 81%

“…24 In Brazil, few services consider the possibility of discharge on the same day, and consequently, the experiences reported are scarce. However, a uni-centric record made a retrospective evaluation of all patients who underwent elective PCI and who were discharged on the same day between January 2009 and March 2012 32 . In that study, 69 patients were detected in the database.…”

Section: Methods Introductionmentioning

confidence: 99%

Intervenção percutânea por via radial e tempo de permanência hospitalar

Oliveira

Pimenta

Ximenes

et al. 2018

Rev enferm UFPE on line.

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RESUMOObjetivo: analisar os fatores de risco relacionados ao procedimento percutâneo por via radial e o tempo de permanência hospitalar. Método: estudo quantitativo, longitudinal, prospectivo, descritivo e unicêntrico. A coleta de dados foi realizada por meio de questionário, com 100 pacientes, em três fases (pré-procedimento, transprocedimento e pós-procedimento), em 24h e após sete dias. Para as variáveis quantitativas, foram utilizados os testes Mann-Whitnney ou t de Student; para as qualitativas, o teste exato de Fisher. Para a associação entre duas variáveis quantitativas, foi utilizado o coeficiente de correlação de Pearson com nível de significância ≤5%. Resultados: 100 pacientes realizaram o procedimento com média de internação de 6,6 dias. Após a associação entre o tempo de permanência e as variáveis clínicas, o p não mostrou valor significante. Conclusão: os resultados aproximam-se mais da realidade dos hospitais do Sistema Único de Saúde; não houve linearidade no tempo de permanência hospitalar quando associado a diferentes fatores relacionados à intervenção percutânea. Descritores: Intervenção Coronária Percutânea; Tempo de Internação; Artéria Radial; Sistema Único de Saúde; Síndrome Coronária Aguda; Fatores de Risco.ABSTRACTObjective: to analyze the risk factors related to the percutaneous radial procedure and length of hospital stay. Method: quantitative, longitudinal, prospective, descriptive and unicentric study. Data was collected through a questionnaire, with 100 patients, in three phases (pre-procedure, transprocedure and post-procedure), in 24 hours and after seven days. For the quantitative variables, the Mann-Whitnney or Student's t tests were used; for the qualitative, Fisher's exact test. For the association between two quantitative variables, the Pearson correlation coefficient was used with significance level ≤5%. Results: 100 patients had the procedure with mean hospitalization of 6.6 days. After the association between the length of stay and clinical variables, p did not show significant value. Conclusion: the results are closer to the reality of the hospitals of the Unified Health System; there was no linearity in the length of hospital stay when associated with different factors related to the percutaneous intervention. Descriptors: Percutaneous Coronary Intervention; Length of hospitalization; Radial Artery; Unified Health System; Acute Coronary Syndrome; Risk Factors.RESUMEN Objetivo: analizar los factores de riesgo relacionados con el procedimiento percutáneo por vía radial y el tiempo de permanencia hospitalaria. Método: Estudio cuantitativo, longitudinal, prospectivo, descriptivo y unicéntrico. La recolección de datos fue realizada por medio de un cuestionario, con 100 pacientes, en tres fases: (pre-procedimiento, transprocedimiento y post-procedimiento), en 24h y después de siete días. Para las variables cuantitativas, se utilizaron las pruebas Mann-Whitnney o t de Student; para las cualitativas, la prueba exacta de Fisher. Para la asociación entre dos variables cuantitativas, se utilizó el coeficiente de correlación de Pearson con nivel de significancia ≤5 %%. Resultados: 100 pacientes realizaron el procedimiento, con promedio de internación de 6,6 días. Después de la asociación entre el tiempo de permanencia y las variables clínicas, el p no mostró valor significativo. Conclusión: los resultados se acercaron más a la realidad de los hospitales del Sistema Único de Salud; no hubo linealidad en el tiempo de permanencia hospitalaria, cuando asociado a diferentes factores relacionados a la intervención percutánea. Descriptores: Intervención Coronaria Percutánea; Tiempo de Internación; Arteria Radial; Sistema Único de Salud; Síndrome Coronária Aguda; Factores de Riesgo.

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“…Since the introduction of the technique, the development and improvement of materials, associated with the greater operator's experience, have made its results as effective as other vascular accesses (femoral puncture and brachial dissection). 10,11 The RIFLE (Radial Versus Femoral Randomized Investigation in ST-Elevation Acute Coronary Syndrome) study was conducted in four centers in Italy, comparing patients with STEMI. 5 Similar to the findings observed in the present study, there was a lower rate of MACE and bleeding associated with the procedures performed via radial access.…”

Section: Discussionmentioning

confidence: 99%

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

Silva¹,

Mangione²,

Wili³

et al. 2018

J Transcat Intervent

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Background: The choice of the radial access for performing percutaneous coronary interventions has grown due to evidence of the greater benefits of the technique, such as reduced vascular complications, lower bleeding rates, early ambulation, shorter hospital stay and lower costs. The present study aimed to analyze patients submitted to percutaneous coronary intervention using the radial access in comparison to the femoral artery access in elective cases or in acute coronary syndromes. Methods: An observational, single center study based on the SAFIRA registry database, which includes patients undergoing percutaneous coronary intervention with drug-eluting stents. The primary endpoint was the incidence of cardiovascular mortality in a 3-year follow-up. Results: A total of 2,453 patients were included, 1,237 of which allocated to the radial group and 1,216 to the femoral group. The prevalence of vascular complications was higher in the femoral group (OR: 15.4; p=0.008), as was the contrast volume used (OR: 1.001; p=0.02). The primary endpoint of cardiovascular mortality in the femoral group was 4.5% vs. 2.3% in the radial group (RR: 1.77; p<0.01). All-cause mortality rates (10.2% vs. 7.4%, RR: 1.37; p=0.03) and major adverse cardiac event rates (12.2% vs. 8.9%, RR: 1; 36; p<0.01) were also higher in the femoral group. When adjusted for relevant clinical variables, the femoral access remained as an independent predictor of cardiovascular mortality. Conclusions: Radial access was effective in reducing mortality, major adverse cardiac events and vascular complications among patients undergoing percutaneous coronary intervention.

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Femoral Versus Radial Access in Primary Angioplasty. Analysis of the ACCEPT Registry

Cited by 6 publications

References 15 publications

Vascular complications in patients who underwent endovascular cardiac procedures: multicenter cohort study

Vascular complications in patients who underwent endovascular cardiac procedures: multicenter cohort study

Intervenção percutânea por via radial e tempo de permanência hospitalar

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

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