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Objectives The present case-control study investigates whether TP53 Arg72Pro variant (rs1042522) serves as a risk factor for recurrent pregnancy loss (RPL) in Greek women. Methods The study group consisted of 100 patients with at least two miscarriages of unexplained etiology, before the 24th week of gestation. The control group included 106 women with no pregnancy loss history. DNA was extracted and genotyped using specific primers for PCR amplification of the Arg72 and Pro72 alleles. Sanger sequencing was used for the discrimination between heterozygotes and homozygotes for Arg72Pro variant. Results This is the first study demonstrating the statistically significant higher frequency of TP53 Arg72Pro variant in Greek RPL women compared to controls (38% vs. 6.6%; OR=8.6682, 95% CI: 3.6446–20.6160; p Conclusions The is the first study disclosing strong evidence that TP53 rs1042522 is significantly associated with a higher risk for recurrent pregnancy loss in Greek women following a dominant model, thus, serving as a genetic marker for identifying women at increased risk of recurrent miscarriages.

In this study, we aimed at delineating the possible effect of estradiol (E2) levels on the day of β-hCG administration on the ovary by analysingthe Embryo Score (ES) of early day 2, 44hrs post insemination. Oocyte donor ovarian stimulation protocols were thus used in order to avoid any possible counteractions of E2 with the endometrium. All oocytes were microinjected and all embryo transfers were fresh.E2 and E2/oocyte correlated positively with the ES on day 2 of embryo development. In contrast, the E2 and E2/oocyte do not appear to significantly affect the implantation and clinical pregnancy rates. Furthermore, E2 levels on the day of β-hCG administration were positively associated with fast and slowly dividing embryos compared to “ideally” dividing embryos on day 2. E2 levels corresponding to the “ideal” ES (E216) on day 2 sonographically translated into 12 mature oocytes. Embryos with “ideal” ES on day 2 were positively associated with implantation and gestational sac rates, as well as lower spontaneous miscarriage rates, in comparison to the fast and slowly dividing embryos. We propose that a) ES on day 2 of embryo development, 44hrs post insemination, is a valuable prognostic marker of embryo quality in ovarian stimulation protocols and b) an ovarian stimulation protocol may most likely be successful if not more than 12 oocytes are collected, i.e. E2 levels do not exceed 3.309pg/ml or on the day of hCG administration.

Objectives: There is a plethora of references in the international bibliography regarding correlation of various risk factors and intrauterine death in the third trimester, such as gestational diabetes mellitus, preeclampsia, endometrial infections as well as endometrial growth restriction. The purpose of the present study is to analyze demographic and socio-economic factors to draw conclusions on improving health services for pregnant women. Methods: 41 cases of intrauterine deaths, after 28 weeks of pregnancy, were studied retrospectively from the archives of the 1st Department of Obstetrics and Gynecology Alexandra Hospital, during a 3-year period (2015-2018). The risk factors assessed, were the age, the race (White/Caucasian, Ethnic, Asian, and Black), the socio-economic status, smoking, body mass index (BMI), educational level, gestational age, monitoring (or lack) of the pregnancy, and pathology observed during the pregnancy though. Results: The average age of women was 31 years old, the average body mass index (BMI) was 27.4, while most of them were White-Caucasian (75,6 %) The majority of women had a low educational and socio-economic level, 68,3 % (28/41) and 61% (25/41) respectively. On top of that, 14/41 (34.1 %) were smokers, the mean age of gestation was the 32 weeks of pregnancy, and the fetal gender was female (63.41%). The gestational preeclampsia was found to be the most important factor for intrauterine death and most of the women had not monitoring during the pregnancy (61%). Conclusions: Interpretation of the results showed that low educational level and low socio-economic level were independent risk factors for endometrial third trimester deaths. On the contrary preeclampsia was the leading cause of death.

Introduction: Recurrent pregnancy loss (RPL) is defined as the spontaneous loss of two or more idiopathic consecutive clinical pregnancies prior to 22 completed weeks of gestation. Association of miRNA polymorphisms with RPL has been investigated as a genetic determinant for the risk of idiopathic RPL. Moreover, mutations in several interleukins’ genes have been also related to RPL. Material and Methods: The study was carried out between September 2019 and September 2021 in Alexandra Maternity Hospital. Two hundred women with at least two consecutive spontaneous abortions (RPL) and 200 women as a control group who have completed one pregnancy were included in this study. Blood samples were collected from which genomic DNA was extracted, and PCR was performed to identify the IL1B -511T>C, IL6 -634G>C, IL-6 -174G > C, miR -149 T>C AND miR-27aA>G genotypes. Results: Of the 5 genes tested, genotype and group correlation were found in IL-1b-511 and miR-27. In specific, in the IL-1b-511 gene, cases have a 77.2% statistically significantly higher relative probability of having the polymorphism (CC genotype) than the control group (OR = 1.772, p = 0.007). In addition, in the miR-27 gene, cases are 3.2 times statistically significantly more likely to have polymorphism (GG) compared to controls (OR = 3.283, p

Oxidative stress may play a role in implantation failure on multiple levels. Oxidative stress is found widely in several biological systems, as well as it acts on various molecular levels with different mechanisms. It has been shown that it is rather the disequilibrium between reactive oxygen species causing oxidative stress and antioxidant mechanisms counteracting their effects, than reactive oxygen species levels themselves. Reactive oxygen species play a role in implantation and fertilisation by acting on different levels of embryo-formation and endometrial changes. Additionally, it is widely abundant in the female reproductive tract including ovaries, oocytes, tubal as well as follicular fluid. Moreover, it has been shown that male fertility is affected by reactive oxygen species by determining sperm quality. Last but not least, oxidative stress may affect IVF indirectly through its actions on peritoneal fluid. As long as research studies on elucidating the development of oxidative stress markers on patients undergoing IVF continue, ever more new possibilities emerge on predicting the pregnancy outcome.

Considering the insufficient evidence supporting an ideal protocol for poor responder management in IVF/ICSI cycles, the aim of the current meta-analysis was to compare GnRH-antagonist versus GnRH-agonist protocols in poor responders, evaluating effectiveness and safety. Meta-analysis was conducted using Medcalc 16.8 version software. Standardized mean differences (SMD), odds ratios (OR), and the respective 95% confidence intervals (CI) were determined appropriately. The Cochran Q statistic and the I2 test were used to assess studies’ heterogeneity. GnRH-agonists were shown to correlate with fewer cancelled IVF/ICSI cycles (p = 0.044, OR = 1.268 > 1, 95% CI 1.007, 1.598), a larger number of embryos transferred (p = 0.008, SMD = − 0.230, 95% CI − 0.400, − 0.0599), and more clinical pregnancies (p = 0.018, OR = 0.748

To ascertain the role of deranged eating behaviours (DEBs) in the development of functional hypothalamic amenorrhoea (FHA) and the reciprocal role of psychopathological traits on both disorders. A prospective case–control study was conducted spanning the period January 2016 to April 2018. Forty-one consecutive FHA females and 86 healthy controls were recruited. We assessed the DEBs and other FHA predisposing factors via self-reported questionnaires. Possible correlations amongst the variables were examined using the Spearman’s correlation coefficient (rho), whilst multivariate logistic regression was carried out to identify independent predictors of DEBs. Mean scores on Eating Attitudes Test-26 (EAT-26) were significantly higher in females with FHA (p

The present case-control study investigates whetherThe study group consisted of 100 patients with at least two miscarriages of unexplained etiology, before the 24th week of gestation. The control group included 106 women with no pregnancy loss history. DNA was extracted and genotyped using specific primers for PCR amplification of the Arg72 and Pro72 alleles. Sanger sequencing was used for the discrimination between heterozygotes and homozygotes for Arg72Pro variant.This is the first study demonstrating the statistically significant higher frequency ofThe is the first study disclosing strong evidence that

Assisted Reproduction Technology (ART) has proven to be a valuable tool for infertile couples. Unfortunately, no perfect ovarian stimulation protocol has been designed and ovarian response shows great variability among women. Pharmacogenomics aims at detecting genetic markers so as to individualize protocols in order to maximize ovarian response to treatment. Follicle Stimulation hormone receptor (FSHR) mutations and single nucleotide polymorphisms have been extensively studied. Splice variants of the FSHR have been detected in women undergoing in vitro fertilisation (IVF). This study aims to determine the presence FSH splice variants in Greek women undergoing IVF. RNA was extracted from cumulus cells from 35 women and analysed by real time PCR. Splice variants were detected by gel electrophoresis. Three cases of deletion of exon 9 and 2 cases of insertion of intron 8 were detected in our study group. No association between the presence of splice variants and response to ovarian stimulation was detected. Two live births were detected one in each variant group. Even though these two types of splice variant detected do not show any clinical correlation it is believed that variants of the FSHR may be associated with poor or high response to exogenous gonadotrophin so further research is necessary.

Introduction: Embryo development is characterized by lack of cell cycle check-points and overexpression of core circadian oscillators. On previous report we have identified several genes over-and under-detected at human embryo blastomeres. In this study, we investigated the expression profile of Kcnh5, KIFC1 and miRNA-302 genes at three pre-implantation stages of mouse embryo development. Material and methods: Total RNA was extracted from mouse embyos at 8-cell, morula and blastocyst stage. The expression profile of Kcnh5, KIFC1 and miRNA-302 was assessed by RT-PCR and the results were normalized with G6pdh expression levels. Results: Kcnh5 showed absence of expression at all stages, indicating novel mechanisms of cell cycle control during blastomeres divisions. KIFC1 showed positive expression at all stages, with decreasing levels as the embryogenesis progresses. This finding indicates that KIFC1 may have more important role at early events. miRNA-302 showed increased levels of expression at all stages, with morula having the highest levels. Therefore, miRNA-302 might play an important role at the events that happen during morula stage such as compaction. Conclusions: Cell cycle control of blastomeres at early embryogenesis might be based on different mechanisms compared to somatic cells and more research is needed in order to reveal crucial cycling elements.

Study question Is GSTM1 polymorphism a putative biomarker of male infertility. Is there a possible correlation between GSTM1 presence, oxidative stress and male infertility? Summary answer A possible correlation may be established between GSTM1 polymorphism, and sperm mobility and morphology. Additionally oxidative potential may also be associated with fertility. What is known already Approximately 7% of men worldwide are affected by male infertility, which contributes to 40–50% of all infertility cases. Basic sperm analysis remains the main procedure of diagnosing male infertility, although there is still doubt whether it provides accurate clinical outcomes More accurate tests are essential for the diagnosis of male infertility. Oxidative stress is involved in the etiology of male infertility, with 30% to 80% of infertile men having increased levels of sperm free radicals. Recent research has shown that oxidative stress when combined with GSTM1-null genotype negatively affected the sperm quality of infertility group compared to the control group. Study design, size, duration Ninety semen samples were collected and divided into 2 groups. The study group consisted of sperm samples from 51 men identified as infertile according to WHO guidelines(case group).Sperm samples from 39 men with normal sperm count parameters (control group) were used for the control group. Participants/materials, setting, methods For all samples a sperm diagram was performed. and DNA was extracted. Polymerase chain reaction with specific for GSTM1 gene primers followed by agarose electrophoresis was applied to detect the presence of polymorphism. The MiOXSYS method was used to detect the oxidative potential. Main results and the role of chance This study shows that in the control group the presence of polymorphism was associated with a reduced number of immobile sperm cells (p = 0,035) while it appears to affect the normal morphology of the sperm(p = 0,042). In the infertility group the presence of the gene was significantly correlated with age(p = 0.046). No statistically significant difference was observed for the presence of the polymorphism between the 2 groups.In addition, we investigated the effect of oxidative potential with the MiOXSYS system and its relationship with sperm parameters. It was found that the two groups differed significantly when measuring oxidative potential, and that oxidoreduction potential affects sperm concentration/ml, total sperm count, type B motility and viscosity in the infertile male group. Limitations, reasons for caution A larger sample size could increase the accuracy of the results. Wider implications of the findings: Studying the relation of the oxidative stress with sperm parameters may lead to the establishment of a genetic profile of increased risk of infertility, which would be of major importance especially in cases of idiopathic infertility. Trial registration number Not applicable

Background Promoter region SNPs in TNF-α have been studied in association with Recurrent Pregnancy Loss (RPL) occurrence in various populations. Among them, −238G > A, −308G > A and − 376G > A have been frequently investigated for their potential role in recurrent abortions. The aim of the present study is to evaluate the correlation among TNF-α 238, TNF-α 308 and TNF-α 376 polymorphisms and recurrent pregnancy loss risk in Greek women. Methods This study included 94 Caucasian women with at least two miscarriages of unexplained aetiology, before the 20th week of gestation. The control group consisted of 89 Caucasian women of proven fertility, with no history of pregnancy loss. DNA samples were subjected to PCR amplification using specific primers. Sanger sequencing was applied to investigate the presence of TNF-α 238, TNF-α 308, TNF-α 376 polymorphisms in all samples. Results The TNF-α 238 and TNF-α 308 variants were both detected in RPL and control groups (7.45% vs 4.49 and 45.16% vs 36.73%, respectively), but with no statistically significant association (p-value 0.396 and 0.374, respectively). The TNF-α 376 variant was not detected at all in both control and RPL groups. When TNF-α 238 and TNF-α 308 genotypes were combined no association with RPL was detected (p-value = 0.694). In subgroup analysis by parity, RPL patients carrying the A allele reported less previous births. Conclusions This is the first study demonstrating TNF-α 238 and TNF-α 308 gene expression and the absence of TNF-α 376 variant in Greek women with RPL. However, no association emerged between each polymorphism studied and the occurrence of recurrent pregnancy loss. Accordingly, TNF-α -308G > A, −238G > A and -376G > A variants are not considered genetic markers for identifying women at increased risk of recurrent pregnancy loss in the Greek population.

Background The aim of this study was to analyze two different polymorphisms, Ser680Asn and -29 (G>A) promoter polymorphism, of the follicle-stimulating hormone receptor (FSHR) gene, individually but also in combination, in a sample of Greek women undergoing in vitro fertilization (IVF) or intracytoplasmic sperm injection (ICSI). Materials and methods One hundred and forty-one women undergoing IVF or ICSI and 94 controls were genotyped by real-time polymerase chain reaction (RT-PCR) for the two FSHR polymorphisms. The association of the alleles with the clinical, biochemical and other parameters concerning the controlled ovarian stimulation (COS) protocol and outcome was investigated, as well as the pregnancy rate. Results The study of each polymorphism individually revealed a positive correlation of the SerSer genotype (Ser680Asn polymorphism) with higher luteinizing hormone (LH) levels on the third day of the menstrual cycle. On the other hand, the A allele for the -29 (G>A) promoter polymorphism correlated with the increased number and quality of cumulus-oocyte complexes (COCs). No differences were detected when the different genotypes of the two polymorphisms were combined – the population study was grouped according to the number of polymorphic alleles they carried (0–4 alleles). Women who presented all polymorphic alleles, AsnAsn/AA, exhibited the lowest LH levels (2.62 ± 0.68 mIU/L), but were rarely detected (n = 2, 1.4% of the studied population). Conclusions The data from this study reflect that the investigation of the combination of polymorphisms, such as FSHR -29 and Ser680Asn, could offer a valuable tool in order to evaluate and anticipate the outcome of the ovulation induction protocols, especially in the group of patients with failed attempts.

To ascertain the role of deranged eating behaviours (DEBs) in the development of functional hypothalamic amenorrhoea (FHA) and the reciprocal role of psychopathological traits on both disorders.A prospective case-control study was conducted spanning the period January 2016 to April 2018. Forty-one consecutive FHA females and 86 healthy controls were recruited. We assessed the DEBs and other FHA predisposing factors via self-reported questionnaires. Possible correlations amongst the variables were examined using the Spearman's correlation coefficient (rho), whilst multivariate logistic regression was carried out to identify independent predictors of DEBs.Mean scores on Eating Attitudes Test-26 (EAT-26) were significantly higher in females with FHA (p 0.0001). Women with FHA were characterised by significantly higher scores at the sub-scale items of dieting (p = 0.03) and bulimia and food preoccupation (p 0.001) compared to healthy controls. Significant difference was also observed between the mean scores of the two groups in all other questionnaires: State-Trait-Anxiety-Inventory (STAI) (p 0.0001), Multidimensional Body-Self-Relations Questionnaire (MBSRQ) (p 0.0001) and International Physical Activity Questionnaire (IPAQ) (p = 0.004). EAT-26 scores were positively correlated with scores on STAI (ρ = 0.26, p = 0.04), MBSRQ (ρ = 0.79, p 0.0001) and IPAQ (ρ = 0.35, p = 0.03). High scores on IPAQ and STAI were correlated with a 12.2-fold (p = 0.008) and 4.3-fold (p = 0.04) increased risk for high scores on EAT-26 respectively.DEBs may occur in FHA populations at a higher frequency compared to the general population. Anxiety and overweight preoccupation may underlie and independently contribute to development and maintenance of both DEBs and FHA. This evidence may have future implications for both screening and interventions that target DEBs and other psychological factors.

BackgroundTumor necrosis factor-alpha (TNF-α) is a pro-inflammatory cytokine which plays an important role in the pathogenesis of many diseases. Endometriosis is one of the most common gynecological diseases. The purpose of this study was to investigate the association of TNF-α-1031T/C polymorphism with the genetic susceptibility of endometriosis in a European population.Materials and methodsIn this case-control study, 51 endometriosis patients and 67 healthy control women participated. We used endometrial tissue from the patients and peripheral blood from the healthy women to extract DNA. Polymerase chain reaction (PCR) analysis and the restriction enzyme Bbs I were used to analyze the -1031 T/C polymorphism in theTNF-αgene promoter region. Statistical analysis was performed using Fisher’s exact test. We also calculated the odds ratios.ResultsIn the group of patients, 66.7% of women were detected with the TT genotype, 33.3% with the TC genotype and 0% with the CC genotype while in the control group, 46.3% had the TT genotype, 47.8% had the TC genotype and 6% had the CC genotype. There was a significant association between the TT genotype with endometriosis (p = 0.03). There was no significant deviation from the Hardy-Weinberg equilibrium.ConclusionsThe TC and CC genotypes appeared more often in the healthy women than the endometriosis patients and this shows that the C allele might have a protective role in endometriosis in the Greek population. Further studies are needed to specify the role of this polymorphism in pathogenesis of endometriosis and the mechanisms that protect the patients from the disease.

Background Infertile women may have underlying genetic abnormalities. There is, at present, a significant number of studies on the relation between the follicle stimulating hormone receptor (FSHR) or anti-Müllerian hormone type II receptor (AMHRII) polymorphisms and response to in-vitro fertilisation (IVF) treatment. However, it is not yet clear which genotype or combination of genotypes is favourable towards a better ovarian stimulation and pregnancy outcome. Materials and methods In this study we assessed the distribution of the genotypes of FSHR Ser680Asn and of AMHRII −482A>G gene polymorphisms in a group of 126 infertile women and a control group of 100 fertile women by using real-time polymerase chain reaction (RT-PCR). Results Statistical analysis showed that the frequency of the genotypes is similar in both control and IVF/ intracytoplasmic sperm injection (ICSI) groups. Further investigation of the frequency of the nine possible combinations of these polymorphisms in the groups revealed no correlation between infertility and combination of the polymorphisms. Women with one polymorphism have on average 5.5 units higher levels of AMH compared to women carrying no polymorphism. In women with no polymorphisms, for each unit of FSH increase, the average concentration of blood AMH is expected to be 72% lower. Conclusion The distribution of the FSHR Ser680Asn and of the AMHRII −482A>G gene polymorphisms, in the Greek population is similar in fertile and infertile women. The study showed that FSH and AMH correlated levels in certain cases could be used to estimate a patient’s ovarian reserve.

Objective We examined trans-radial approach (TRA) use in coronary angiographies (CAs) as well as in percutaneous coronary interventions (PCIs) in specific regions of Greece, its distribution in public and private catheterization laboratories (CLs) and its preference by operators. Reliable data regarding the use of TRA are not available in Greece. Methods The study was performed in northern and central Greece, which constitutes 35.32% of the national population. This study focused on the years 2004, 2009 and 2013. Results There are 12 CLs. CAs performed using TRA were 0.43% in 2004, 12.28% in 2009 and 39.81% in 2013, whereas PCIs performed using TRA were 0.38%, 9.20% and 39.48%, respectively. Operators familiar with TRA, but who performed TRA electively, were 13.33% in 2004, 60.38% in 2009 and 42.37% in 2013. However, operators performing TRA routinely were 2.2%, 5.66%, and 49.15%, respectively. In 2013, there was a 3.76% decrease in CAs and 4.51% decrease in PCIs compared to 2009; in private CLs, there was a 29.63% decrease in CAs and 34.72% decrease in PCIs performed, which was contradictory to the 27.27% increase observed in CAs and 29.83% increase in PCIs in public CLs. Conclusions This is the first study to reveal the volumes and trends in interventions performed via TRA across central and northern Greece. TRA has gained a reputation among operators in both public and private CLs. Due to the financial crisis in Greece, catheterizations have been diminished, whereas private CLs have lost a great amount of their turnover.

Obtaining an adequate number of good quality oocytes while minimizing adverse drug reactions (ADRs) and cycle cancellation rates is considered the gold standard in controlled ovarian hyperstimulation (COH) for fertility treatment. Patients who undergo IVF/ICSI cycles tend to present with different responses to exogenous gonadotrophin administration. Research has shown that the secret probably lies in the various single nucleotide polymorhisms (SNPs) in their receptor genes. The decryption of human genome provided specialists with additional information in assessing and even predicting ovarian response to COH. In this context, the study of Pharmacogenomics, Pharmacogenetics and SNPs unravels as a promising field in optimizing fertility treatment. Several SNPs in FSH and estrogen receptor genes have been detected so far, but only three of them, one in FSH receptor and two in estrogen receptor genes have been associated with ovarian response to COH. It seems that the Asn/Ser variant of the FSH receptor functions more efficiently, while the Ser/Ser and Asn/Asn variants have a tendency to resist to FSH stimulation. With regards to estrogen receptor 1 (ESR1), the Pvull and the Xbal polymorphisms seem to be associated with differences in the response to ovarian stimulation, while the Rsal polymorphism in estrogen receptor 2 (ESR2) is currently under investigation. There exists evidence supporting the hypothesis that a set of genes, all related to the FSH hormone mechanism of action, may participate along with other factors to the control of ovarian response to FSH, thus a cautious interpretation of polymorphism detection results is considered mandatory. However, identifying potential genetic markers that could predict ovarian response and implementing them in routine screening tests for every woman entering an IVF/ICSI cycle, would be able to tailor fertility treatment to each patients needs thus maximizing the success rate and eliminating potential side-effects of fertility drugs.

Purpose: Previous studies in humans concluded that a multigenic model including specific FSHR, ESR1 and ESR2 genotype patterns may partially explain the poor response to FSH. The aim of our study is to analyse three different loci -polymorphisms in ESR1 Pvu II, ESR2 Rsa I and Ser680Asn FSH receptor gene- in a Greek population and their involvement in stimulation outcome and pregnancy rates. Methods: Each locus was studied alone, and in combination with the others. We performed both restriction fragment length polymorphism analysis and real-time polymerase chain reaction. A total of 109 normally ovulating female patients underwent IVF or ICSI. Results: Studying each locus alone, no significant results were drawn for ESR1 and ESR2 genes. Concerning the FSHR polymorphism, the women carrying the AA variant presented higher total amount of gonadotrophins used (P=0,048) and tended to have higher number of stimulation days (P=0,057). Considering the ESR1 and FSHR gene polymorphisms in combination, the TC/SA combination presents the highest number of pregnancies in poor responders group (3/4 pregnancies carried this genotype), in good responders group (4/12 pregnancies carried this genotype) and in the total population (10/26 pregnancies carried this genotype). Except the CC/AA combination, all other genotype combinations presented incidence of pregnancy, with TC/SA having the highest incidence. The CC/AA genotype presents the worst profile of ovulation induction, confirming a poor responder profile: the total amount of gonadotrophins used was highest in CC/AA group (P < 0,05). The peak E2, the number of follicles and of retrieved oocytes and the pregnancy rate were significantly lower (P < 0,05). This genotype combination seems to be over-presented in the poor responders group in a statistically significant way (P=0,038). Women with CC/AA combination have 1,5-2,4 times more risk to be poor responders in comparison with women that do not carry that combination. Conclusion: This study supports the hypothesis that a multigenic model, including the well studied ESR1 and FSHR genes is involved in the controlled ovarian stimulation outcome indicating that the CC/AA genotype presents the worst ovulation induction profile, while the TC/SA genotype presents the higher number of pregnancies in our population.

In this brief report, we present our experience from placing temporary pacing electrodes through peripheral venous access sites, at bedside, in a series of patients needing temporary pacing.Consecutive patients requiring temporary pacing were selected. The median cubital or the basilic vein of the left upper extremity were used for catheterization at the bedside in all cases.25 patients (17 men, age 64.6 ± 11.8) were included. The procedure was successful in 21 cases (84%), 18 of which were completed without the need for fluoroscopic guidance. The pacing leads remained for 4.2 ± 2.2 days. As expected, no serious complications related to venous puncture were observed. Although patients were allowed to be mobilized within the ward and engage in limited movements of the catheterized arm, in only one case was the lead displaced, requiring repositioning.We provide observational evidence that the use of peripheral venous access for temporary pacing lead insertion (with no fluoroscopic guidance, as default strategy) is a safe and feasible choice that might be considered as an alternative to central vein catheterization.

The transfemoral approach (TFA) has been the mainstay for arterial access during percutaneous coronary intervention (PCI) in the setting of acute ST-segment elevation myocardial infarction (STEMI). However, the transradial approach (TRA) has been shown to be an equally effective and possibly safer way of performing primary PCI (pPCI).The study population included 98 serially recruited patients who underwent pPCI in our institution. All patients were clinically followed during their hospital stay (6.4 ± 3.1 days).In the 98 patients included in the study, 65 procedures (66.3%) were completed via TRA, whereas the remaining 33 procedures (33.7%) used TFA. Door-to-balloon time was similar (57 ± 19 min vs. 54 ± 15 min, p=ns). Patients in the TRA group were mobilized sooner (28 ± 9 hours vs. 36 ± 13 hours, p0.05). Hospital stay was significantly shorter in the TRA group (6.0 ± 3.2 days vs. 7.1 ± 2.8 days, p0.05). TRA and TFA did not differ significantly as to the incidence of death, non-fatal myocardial infarction or subacute stent thrombosis, but major access-related vascular complications were significantly more frequent in the TFA group (2% vs. 15%, p0.01). Cerebrovascular events did not differ between TRA and TFA.Compared to TFA, TRA seems to be associated with a lower incidence of bleeding complications, as well as earlier mobilization and discharge from hospital. It is conceivable that TRA could become the first choice in the treatment of STEMI patients in the near future, while TFA is kept as an alternative.