Plasma-mediated immobilisation of recombinant tropoelastin dramatically enhances vascular biocompatibility of metals: Implications for coronary stents

Abstract

observational data has even suggested that mortality may be lower in comparison to femoral artery access. However, a significant learning curve exists for the technique, leading to potentially longer procedural times and increased radiation doses. We sought to investigate fluoroscopy times and contrast volumes when these procedures were performed by operators experienced in both techniques. Methods: PCI performed on consecutive patients (n= 422) under the care of two high-volume consultant radial operators from 2007 to 2008 were included for analysis. These included all comers regardless of approach or acute infarction. Fluoroscopy times and contrast volumes were recorded along with patient demographics. Results: Mean age was 64.6± 12.8 years (74% male). Radial approach was performed in 65.4% (n= 276) where the mean number of stents inserted were less than femorals (1.6 stents vs. 1.8 stents; p= 0.043). There were no differences between radial and femoral approach inmean fluoroscopy times (17.2min vs. 18.6min; p= 0.29) or contrast volumes (273mL vs. 285mL; p= 0.33). These held true even after adjusting for the number of stents inserted per patient. Primary PCI was performed in 81 patients (19.4%) of which 69% were via radial approach. Similarly, in this subgroup there were no significant differences in fluoroscopy times (14.7min vs. 14.2min; p= 0.81) or contrast volume (246mL vs. 220mL; p= 0.18). In the elective PCI subgroup, there was a trend in favour of radial approach with fluoroscopy time (17.9min vs. 19.5min; p= 0.27) and contrast volume (280mL vs. 297mL; p= 0.19). Conclusion: PCI via radial approach performed by high volume radial operators did not result in significantly increasedfluoroscopy timeor contrast volume.With experience, the radial approach can be performed as efficiently as femoral even in the setting of primary PCI. doi:10.1016/j.hlc.2009.05.553