Abstract
Vascular access complication rate after PTCA is increased in elderly patients (pts). The goal of this study is to determine whether the use of the new trans radial approach (TRA) would decrease the rate of vascular complications. Between February and August 1994, 135 consecutive pts ≥ 70 years old underwent a coronary angioplasty via TRA using a 6F guiding catheter. There were 96 males, 39 females, with a mean age of 74.9 ± 3.8 years (70–87), 61% had unstable angina, 17% had a recent myocardial infarction, 73% had multivessel disease. Conventional balloon angioplasty was performed in 94 pts (70%), Palmaz-Schatz stent implantation in 29 pts (21%) and rotational ablation using the rotablator(l.25 or 1.5 mm burr diameter) in 12 pts (9%). In hospital major cardiac events occurred in 3 pts (2%): one acute closure after balloon angioplasty successfully recanalized, one non a-wave MI after rotablator procedure and one death three days after coronary stent implantation. Vascular access complications (2%) included 2 hematoma and one surgical repair for A V fistula. No bleeding requiring blood transfusion occurred. This new TRA for coronary revascularization in elderly can be considered a safe and effective procedure, with a low rate of major cardiac and arterial puncture site complications.
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