Search

Background: The use of the distal radial access for invasive coronary procedures has been rapidly adopted by the medical community, but with no evaluation of efficacy and safety outcomes of this approach. The objective was to evaluate the rate of radial artery occlusion involved in this technique, using Doppler ultrasound. Methods: This was an observational, retrospective study involving patients undergoing invasive diagnostic or therapeutic coronary procedures via distal radial access, with assessment of the radial artery patency by Doppler ultrasound. The primary outcome analyzed was the rate of radial artery occlusion. Results: Between July and December 2020, 51 patients underwent procedures via distal radial access, with assessment of the radial artery patency, out of a total of 603 patients seen during this period. Patients were aged 58±10.8 years, 68.6% were male, 26.9% had diabetes mellitus, and 68.6% were diagnosed with acute coronary syndrome. Diagnostic procedures were performed in 68.2% of sample, and 23.5% of patients had undergone a previous use of the ipsilateral proximal radial access. Doppler ultrasound was performed over a mean period of 24 hours, and no occlusion of the radial artery was observed, with mean time for sheath insertion of 1.9 minutes. There was no major vascular complication. In two patients, pain was observed at the access point; another two had a small subcutaneous hematoma, and, one patient, presented with moderate spasm. Conclusion: The use of distal radial access was associated with a low rate of hemorrhagic complications in the access route, and absence of occlusion of the radial artery by Doppler ultrasound assessment.

RESUMO Introducao Mediante a impossibilidade de utilizacao do acesso radial em procedimentos coronarios invasivos, a tecnica ulnar apresenta-se como alternativa factivel e segura. O objetivo do presente estudo foi caracterizar sua relevância na pratica diaria de um centro que adota a estrategia radial como primeira opcao. Metodos A amostra foi extraida de um registro prospectivo unicentrico, no periodo de maio de 2008 a outubro de 2018, incluindo a totalidade de pacientes submetidos a procedimentos coronarios invasivos em hospital terciario de [...]

Background Ad hoc percutaneous coronary intervention via radial access has become frequent in interventional cardiology services, with reduced bleeding rates, vascular complications and costs. There are few reports in the medical literature on radiological exposure rates (kerma area product − Kap, and incident air kerma − Iak) in these procedures, when they are performed via radial access. The objective of the study was to compare radiological variables in staged percutaneous coronary interventions with ad hoc interventions via radial access. [...]

RESUMO Introducao Recentemente descrita, a puncao distal da arteria radial esquerda atraves da tabaqueira anatomica apresenta-se como um refinamento da tecnica. Exibe como potencial beneficio maior conforto ao paciente e ao operador, alem da manutencao do fluxo sanguineo pelo arco palmar superficial, em caso de oclusao da arteria radial. Nosso objetivo foi avaliar a seguranca e a factibilidade dessa nova tecnica. Metodos Registro prospectivo envolvendo pacientes submetidos a procedimentos coronarios invasivos diagnosticos ou terapeuticos pela porcao distal da via radial [...]