Abstract 224: Reducing Fluoroscopy Times and Contrast Volume Significantly in the Therapy of Acute Coronary Syndromes by Performing Angioplasty Through Cordis 6F Diagnostic Catheters - Changing the Interludes

Abstract

Aims: To reduce fluoroscopy times and contrast volume in the therapy of acute coronary syndromes by performing angioplasty and stenting through 6F Cordis diagnostic catheters in acute coronary syndromes. Methods: 414 patients underwent angioplasty and stenting with acute coronary syndromes with 6F Cordis diagnostic catheters. Primary angioplasty was seen in 124 cases. Baseline renal failure or elevated creatinine >2mg/dl was seen in 15 cases. Baseline creatinine more than 4mg/dl was seen in 6 cases. N acetyl cystenine was given to patients orally for 2 days when creatinine was >1.3mg/dl. All procedures were performed through femoral route only using 6F Cordis diagnostic catheters only. The details of the patients and fluoroscopy times were analysed retrospectively. All patients were followed up at 30 days after discharge. Results: In total 511 lesions and 575 stents were used in the angioplasty procedures. Retrospective analysis showed the mean contrast volume per patient was 27±8 ml. Also, the mean fluoroscopy time was 5.8±2.7 min/patient including the angiogram prior to the angioplasty. In 11% cases where the procedure time was >10 mins, and if these cases were eliminated from analysis the mean fluoroscopy time was 4.4±1.8 min/patient including the angiogram before the angioplasty. There were 4 patients who expired, and 3 of these patients had cardiogenic shock, one patient expired due to possible acute stent thrombosis after discharge. In total, 14 cardiogenic shock patients were treated. Two patients had acute stent thrombosis and were treated with an additional stent. One patient required dialysis who had a baseline creatinine of 5.6mg/dl at presentation. Congestive cardiac failure was seen in 21 cases who were treated with oxygen and early BIPAP ventilation, and frusemide injections and infusion. A variety of stents from various companies could be used in the procedures. Buddy wires were used in 12 patients. Proximal mild edge dissection was seen in two patients after stenting and it was treated with a additional stent. Also, it is feasible to perform IVUS during the procedures. Conclusion: It is feasible to safely reduce the fluoroscopy times and contrast volume by performing angioplasty through 6F Cordis diagnostic catheters in acute coronary syndromes.