Intervenção coronária percutânea em tronco de coronária esquerda não protegido: acesso radial vs. femoral

Ryan Falcão,Ana Falcão,Sandra Falcão,João Falcão,Breno Falcão

doi:10.31160/jotci2018;26(1)a0008

Abstract

ABSTRACT Background Percutaneous intervention for obstructive lesions of the unprotected left main coronary artery is complex. Choosing the vascular access can be decisive to a successful procedure. The objective of the present study was to describe the characteristics and hospital outcomes of patients with unprotected left main coronary artery disease and compare the radial and femoral access approaches. Methods Clinical and angiographic data, access routes and hospital outcomes of patients that have undergone percutaneous coronary intervention of the unprotected left [...]

Highlights

Obstructive lesions of the unprotected left main coronary artery (LMCA), especially those involving its distal portion, are complex percutaneous procedures,J Transcat Intervent. 2018;26:1-5requiring the use of multiple balloons and interventional techniques with two or more stents
The objective of the present study was to describe clinical and angiographic characteristics and hospital outcomes of patients undergoing percutaneous coronary intervention (PCI) of the unprotected LMCA, comparing the radial and femoral access approaches. This is a retrospective study with information collected from data registered in the Central Nacional de Intervenções Cardiovasculares (CENIC; http://www.corehemo.net/), of the Sociedade Brasileira de Hemodinâmica e Cardiologia Intervencionista (SBHCI), created in 1991
Data for the study were collected from 734 patients presenting unprotected LMCA disease treated with PCI, from June 2006 to March 2016

Summary

Introduction

Requiring the use of multiple balloons and interventional techniques with two or more stents. The femoral approach allows using larger diameter catheters (7 and 8 Fr), providing greater support and facilitating the treatment of bifurcations, especially when using balloons and large diameter stents simultaneously. Despite presenting a shorter learning curve, the femoral technique is associated with a higher rate of vascular and hemorrhagic complications.[1, 2]. The radial approach is much safer, reducing the occurrence of complications related to the arterial puncture site, and reducing mortality in the context of acute coronary syndromes.[3] it has a longer learning curve and limitations during complex cases that require more substantial support and larger diameter catheters.[4,5,6,7]

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Conclusion