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

Abstract

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-

Incidence of hemorrhagic complications with use of a radial compression device: a cohort study

“…The use of radial access is recognized as a safe way of performing cardiac diagnostic catheterization and percutaneous coronary interventions (PCI), and in the literature, different compression methods for hemostasis have been described (1,(3)(4) . The present study examined the incidence of hemorrhagic complications in patients undergoing radial cardiac catheterization with use of a hemostatic device for radial compression during a 4-hour period.…”

“…The radial pathway has been widely used in percutaneous cardiovascular procedures, since it allows performing complex interventions with reduction of intensity and duration of hemostasis after arterial pressure, and is associated with lower rates of vascular complications and major bleedings with potential impact on morbidity and mortality (1)(2)(3)(4) . Another important factor of this approach is the preferential choice by patients, because it provides greater comfort in recovery after the intervention by enabling early ambulation and shorter hospitalization time (5)(6) .…”

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

“…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.…”