Angioplastia coronária nas indicações off-label: comparação das vias radial vs. femoral

Abstract

ABSTRACT Coronary Angioplasty in Off-Label Indications:Comparison of Radial vs. Femoral Approach Background: There is increasing interest in the use of theradial approach in diagnostic and therapeutic proceduresdue to several advantages such as patient comfort in theimmediate post-procedure with early return to daily routineactivities, decreased hospitalization time and consequentreduction of hospital costs and low puncture site complicationrates when compared with the femoral approach, reducingthe rate of major bleeding, which is in turn related toincreased risk of death and ischemic events. Method: Retrospective analysis of 1,807 consecutive patients under-going off-label percutaneous transluminal coronary angio-plasty (PTCA) from September 2006 to December 2009.The outcome of patients undergoing PTCA using the radialand femoral approaches during hospitalization and latefollow-up were compared. Results: The radial approachprevailed in younger, male patients with lower angiographiccomplexity, which was due to the learning curve. Majoradverse cardiac events (MACE), death and target-vesselrevascularization rates were lower when the radial approachwas used, both during hospitalization and in the late fol-low-up due to a more favorable clinical-angiographic pro-file. The femoral approach was an independent predictorof hospital MACE. The adjusted survival curve, however,showed that the access route did not have a significantimpact on long-term clinical events.