PPG - Medicina (Cardiologia)

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https://hdl.handle.net/11600/61143

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Navegando PPG - Medicina (Cardiologia) por Palavras-chave "Acesso Arterial Transradial Distal"

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    Acesso arterial transradial distal como via de escolha preferencial para cineangiocoronariografias e intervenções coronarianas percutâneas
    (Universidade Federal de São Paulo (UNIFESP), 2021) Oliveira, Marcos Danillo Peixoto [UNIFESP]; Caixeta, Adriano Mendes [UNIFESP]; Universidade Federal de São Paulo
    Background: distal transradial access (dTRA) as a refinement of the conventional transradial has several potential advantages in terms of patient and operator comfort, faster hemostasis, and risk of proximal radial artery occlusion and has recently gained large popularity worldwide. We aim to describe our real-world experience with dTRA as default for routine coronary angiography (CAG) and percutaneous coronary intervention (PCI) in a broad sample of all-comers patients. Material and methods: from February 2019 to June 2021, 2,913 consecutive all-comers patients submitted to CAG and/or PCI via dTRA have been enrolled into the DIStal TRAnsradial access as default approach for Coronary angiography and intervenTIONs (DISTRACTION) registry and their data were analysed. Results: mean patient age was 63±14.1 years-old, most were male (66.5%), with hypertension (77.9%) and acute coronary syndromes (51%). Overall, 668 (22.9%) patients had ST-elevation myocardial infarction and 73 (2.5%) presented to the cath lab in cardiogenic shock. We had only 2.4% access site crossovers, 20% of these performed via contralateral dTRA; then, only in 57 (2%) patients dTRA sheath insertion could not be obtained, despite successful distal radial artery puncture (in all 2,913 patients). Right dTRA was the most frequent (79.8%), followed by left dTRA (10.3%), redo ipsilateral dTRA (9.2%) and simultaneous bilateral dTRA (0.7%). For 60% of all patients, PCI was performed and left anterior descending was the most prevalent target coronary territory (47.7%). Distal and proximal radial artery pulses were palpable in all patients after hemostasis. No major adverse cardiac and cerebrovascular events and no major complications related to dTRA were recorded. Conclusions: dTRA as default for routine CAG and PCI by experienced transradial operators appears to be feasible and safe.