Angiography Intervention Research Articles

Head and neck angiography in the pediatric population: single-center experience with indications, safety, feasibility, and technical differences among infants, childhood, and adolescents.

Pediatric patients are candidates for head and neck endovascular procedures less frequently than adults. Data on utilization, feasibility, safety, and technical details of head and neck angiography in the pediatric population are scarce. The authors performed a retrospective review of their center's endovascular database to identify all patients ≤ 18 years of age who underwent diagnostic or interventional catheter-based angiography of the head and neck. Procedure-related variables for identified patients were compared across infancy (birth to 2 years), childhood (> 2-11 years), and adolescence (> 11-18 years). One hundred twenty-one pediatric patients who underwent 274 angiogram procedures were included in this study. Of these angiograms, 197 were diagnostic and 118 were interventional (including 41 of the diagnostic angiogram procedures that were performed concurrently with the intervention). The most common indications for diagnostic angiograms were suspected vascular malformations in 52 cases (26.4%) and aneurysms in 23 (11.7%). The rate of positive findings on diagnostic angiograms ranged from 27.3% to 80% according to the indication. Access site-related complications were observed after 2 punctures (0.7%). Procedure-related complications occurred in 3 patients (1.1%). In adolescents, the rates of general anesthesia use and sheathless access were significantly lower (each p < 0.001), and the rates of radial artery access (p < 0.001); 5-French (5F) (p = 0.01), 6F (p < 0.001), and 8F (p = 0.03) access; and closure device usage (p < 0.001) were significantly higher. In infants, the rates of ultrasound guidance, 4F access, and failure of the primary puncture site were significantly higher (each p < 0.001). Head and neck angiograms in the pediatric population were feasible and safe in the authors' overall experience. Technical differences were observed across the infant, childhood, and adolescent groups, but safe outcomes were similar throughout these age ranges.

ROLE OF PREOPERATIVE EMBOLIZATION IN BONE TUMORS- A case control study

Preoperative embolization of bone tumor is a minimally invasive angiographic intervention technique and effective adjuvant treatment option for bone tumors. In 1975, Feldman was the rst to use the pre-operative arterial embolization technique to downstage the vascularity of bone tumors, thus reducing blood loss during surgery. Surgery remains the mainstay treatment option for bone tumors. Embolization reduces tumor vascularity and hence decreases intraoperative blood loss and intraoperative blood transfusion. It enables more accurate delineation of tissue planes during surgery, resulting in complete removal of the bone tumor. The most frequent bone tumors that typically need preoperative embolization are those difcult to operate on because of their huge size, high degree of vascularity, proximity to critical tissues, or difcult surgical access. PVA particles are regarded as a workhorse in preoperative transarterial embolization and thus used commonly as an embolizing agent. It is safe procedure and therefore can be used as part of the multidisciplinary approach to the management highly vascular bone tumors.

Urgent Combination of Robotic and MIDCAB Coronary Revascularization in a Morbidly Obese Patient.

In this article, we focus on the important role of robot-assisted coronary surgery by reporting the successful case of a morbidly obese male (body mass index = 58 kg/m2) who presented to our center with severe coronary disease. A 54-year-old morbidly obese male presented with acute chest pain and was diagnosed with coronary artery disease. The culprit lesion was the left anterior descending (LAD) coronary artery. A percutaneous coronary intervention angiography attempted in a university hospital was not successful. Our heart team chose a hybrid robot-assisted revascularization (HCR) strategy based on the patient's body size. The patient underwent left internal thoracic mammary artery to LAD bypass with uneventful postoperative recovery. Robotic HCR is a valuable strategy in morbidly obese patients undergoing coronary artery bypass grafting.

Indicative factors for surgical or angiographic intervention in hemodynamically stable patients with blunt abdominal trauma: A retrospective cohort study.

The standard of care for intraperitoneal injury in hemodynamically stable patients after blunt abdominal trauma has been replaced by non-operative management (NOM). However, selective NOM, depending on the situation, seems necessary in determining the treatment plan. In this study, we attempted to identify risk factors for surgical or angiographic intervention (SAI) in hemodynamically stable blunt abdominal trauma patients. This retrospective study which included adult patients who were brought to a regional trauma center was conducted from March 2015 to October 2019. We evaluated the characteristics of blunt abdominal trauma patients and analyzed factors that were related to the requirement of SAI in these patients. Patients were divided into SAI and conservative management (CM) groups. We reviewed 1,176 patients, and after exclusions, of whom 248 blunt abdominal trauma and free fluid observed on CT were identified. The mean pulse rate was higher in the SAI than in the CM (P=0.025). Laboratory findings showed that lactate and delta neutrophil index (DNI) levels were higher in the SAI than in the CM (P=0.002 and 0.026 respectively). Additionally, the mean free fluid size in the SAI (85.69mm) was significantly larger than that in the CM (68.12mm; P=0.001), and blush was more frequently observed in the SAI (P<0.001). In multivariate analysis, only blush was an independent prognostic factor for SAI (OR 11.7, 95% CI, 5.1-30.8, P<0.001). In hemodynamically stable patients with blunt abdominal trauma, blush but also high lactate and DNI are associated with the requirement of interventional radiology and/or surgery.

Abstract TMP54: Increased Thrombectomy Time Saving From Melbourne Mobile Stroke Unit Operation During Covid-19 Pandemic

Introduction: Mobile stroke units (MSU) have demonstrated major time savings for thrombolysis but mixed evidence for endovascular thrombectomy (EVT). COVID-19 precautions have dramatically slowed EVT workflows across Australia and we therefore aimed to examine the effect of the Melbourne MSU on thrombectomy times before and during the current pandemic. Methods: Patients receiving EVT facilitated by the Melbourne MSU from 2017-2021 were compared to non-MSU patients (metropolitan direct and secondary transfer for EVT) admitted to the largest Melbourne EVT centre. Quantile regression analysis was used to calculate the median time difference (50 th quantile) between MSU and non-MSU patients before and during the pandemic, grouped by patients within an EVT centre ambulance catchment or those outside (who either received inter-hospital transfer or MSU-facilitated bypass to an EVT centre). Results: A total of 402 patients (112 MSU) were included. Pre-pandemic, no reduction in dispatch to arterial access time was seen for MSU patients within an EVT centre catchment (median 11min slower, p=0.38). However, a significant time saving was observed during the pandemic (median 29 min faster, p&lt;0.001, p-interaction=0.0065). MSU care reduced hospital arrival to arterial access time by median 19min pre-pandemic vs 40 min during the pandemic, p-interaction&lt;0.001). The pandemic did not alter MSU-related time savings for patients located outside of an EVT centre catchment. Conclusions: Melbourne MSU facilitation of EVT during the COVID-19 pandemic resulted in greater time savings for patients located close to a thrombectomy centre, while substantial time savings were maintained for those needing bypass from the local non-EVT hospital. This suggests that MSU operation enables streamlined EVT workflows during the pandemic by providing early pre-hospital notification and interventional angiography activation.

Effect of intra-arterial nimodipine on iatrogenic vasospasms during endovascular stroke treatment – angiographic resolution and infarct growth in follow-up imaging

PurposeThe treatment of vasospasms during endovascular stroke treatment (EST) with intra-arterial nimodipine (NM) is routinely performed. However, the efficacy of resolving iatrogenic vasospasms during the angiographic intervention and the infarct development in follow-up imaging after EST has not been studied yet.MethodsRetrospective single-center analysis of patients receiving EST for anterior circulation vessel occlusion between 01/2015 and 12/2021. The primary endpoint was ASPECTS in follow-up imaging. Secondary endpoints were the clinical outcome (combined endpoint NIHSS 24 h after EST and difference between modified Rankin Scale (mRS) before stroke and at discharge (delta mRS)) and intracranial hemorrhage (ICH) in follow-up imaging. Patients with vasospasms receiving NM (NM+) or not (NM-) were compared in univariate analysis.ResultsVasospasms occurred in 79/1283 patients (6.2%), who consecutively received intra-arterial NM during EST. The targeted vasospasm angiographically resolved in 84% (66/79) under NM therapy. ASPECTS was lower in follow-up imaging after vasospasms and NM-treatment (NM – 7 (6–9), NM + 6 (4.5-8), p = 0.013) and the clinical outcome was worse (NIHSS 24 h after EST was higher in patients treated with NM (median, IQR; NM+: 14, 5–21 vs. NM-: 9, 3–18; p = 0.004), delta-mRS was higher in the NM + group (median, IQR; NM+: 3, 1–4 vs. NM-: 2, 1–2; p = 0.011)). Any ICH (NM+: 27/79, 34.2% vs. NM-: 356/1204, 29.6%; p = 0.386) and symptomatic ICH (NM+: 2/79, 2.5% vs. NM-: 21/1204, 1.7%; p = 0.609) was equally distributed between groups.ConclusionIntra-arterial nimodipine during EST resolves iatrogenic vasospasms efficiently during EST without increasing intracranial hemorrhage rates. However, patients with vasospasms and NM treatment show higher infarct growth resulting in lower ASPECTS in follow-up imaging.

Renal Autologous Cell Therapy in Type 2 Diabetes with Late Stage 4 Diabetes-Related Chronic Kidney Disease: Trial Design and Early Analysis

Introduction: Cell-based therapies potentially delay the trajectory toward end-stage kidney disease (ESKD) in late stage 4 diabetic chronic kidney disease (DKD). We describe the trial design, baseline patient characteristics, and early results of an IRB-approved phase II multicenter clinical trial, utilizing Renal Autologous Cell Therapy (REACT) in adults with pre-ESKD due to type 2 DKD. The trial objectives were safety and tolerability of REACT by assessment of the procedure, product administration, and renal-specific adverse events in addition to evaluate the impact on renal function following injection. Methods: Ten adults with an eGFR of 14–20 mL/min/1.73 m² were enrolled in a single-arm open-label trial. Following a percutaneous kidney biopsy, an ex vivo expansion of selected renal cells that form the REACT was injected into the cortex of the biopsied kidney with CT image guidance. Each participant received two doses of the REACT product at 6-month intervals. A 6-month observation pre-trial was required to establish patients’ “own” baseline and rate of DKD progression. Results: Five men and 5 women underwent 19 REACT injections (1 participant received only one injection). Their baseline characteristics were as follows: 3 Hispanic/Latino, 7 non-Hispanic, 7 white; mean (SD) age: 58.9 years (5.22), BMI 35.8 (8.2), eGFR (sCR) 15.5 (2.72), eGFR (sCR + Cys-C) 17.7 (3.67) mL/min/1.73 m², sCr 3.6 mg/mL (0.73), Cys-C 2.6 mg/mL (0.52), and log random UACR 7.9 mg/g (1.01). The pre- and post-injection eGFR slope was −6.5 mL/min/1.73 m² and −3.9 mL/min/1.73 m². No cell-related adverse events occurred, and two procedure-related hematomas required observation without transfusion or angiographic interventions. Dialysis was delayed a mean of 16 months (range 6–28 months). At 15 months, 2 patients (20%) have eGFR slope stability and have not commenced renal replacement therapy. Conclusion: Trials that include patients with an eGFR of <20 mL/min/1.73 m² are uncommon, and none to date involve autologous homologous cell-based treatments. REACT has the potential to stabilize or delay dialysis in high-risk late stage 4 DKD.

Admission Hypocalcemia and the Need for Endoscopic and Clinical Interventions among Patients with Upper Gastrointestinal Bleeding

Introduction: Calcium is an essential co-factor in the coagulation cascade, and hypocalcemia is associated with adverse outcomes in bleeding patients, including trauma patients, women with postpartum hemorrhage, and patients with intracranial hemorrhage. In this retrospective, single-center, cohort study, we aimed to determine whether admission-ionized calcium (Ca⁺⁺) is associated with higher rates of therapeutic interventions among patients presenting with acute nonvariceal upper gastrointestinal bleeding (NV-UGIB). Methods: Adult patients admitted due to NV-UGIB between January 2009 and April 2020 were identified. The primary outcome was defined as a need for clinical intervention (two or more packed cell transfusions, need for endoscopic, surgical, or angiographic intervention). Univariate and multivariable logistic regression analyses were performed to determine whether Ca⁺⁺ was an independent predictor of the need for therapeutic interventions. Propensity score matching was performed to adjust the imbalances of covariates between the groups. Results: A total of 434 patients were included, of whom 148 (34.1%) had hypocalcemia (Ca⁺⁺ <1.15 mmol/L). Patients with hypocalcemia were more likely to require therapeutic interventions than those without hypocalcemia (48.0% vs. 18.5%, p < 0.001). Specifically, patients with hypocalcemia were more likely to require endoscopic intervention for control of bleeding (25.0% vs. 15.7%, p = 0.03) and multiple packed cell transfusions (6.8% vs. 0.3%, p < 0.001). Additionally, they had significantly longer hospital stay (5.0 days [IQR 3.0–8.0] vs. 4.0 days [IQR 3.0–6.0], p = 0.01). After adjusting for multiple covariates, Ca⁺⁺ was an independent predictor of the need for therapeutic intervention (aOR 1.62, 95% confidence interval [CI] 1.22–2.14, p < 0.001). The addition of Ca⁺⁺ to the Modified Glasgow Blatchford score improved its accuracy in the prediction of therapeutic intervention from AUC of 0.68 (95% CI 0.63–0.72) to 0.72 (95% CI 0.67–0.76), p = 0.02. After incorporation of the propensity score, the results did not change significantly. Conclusion: These findings suggest that hypocalcemia is common and is associated with an adverse clinical course in patients with NV-UGIB. Measurement of Ca⁺⁺ on admission may facilitate risk stratification in these patients. Trials are needed to assess whether the correction of hypocalcemia will lead to improved outcomes.

Coil embolization of a fistula from the right inferior phrenic artery to the right pulmonary artery with involvement of further arteries: A rare case report

A 51-year-old female patient presenting dyspnea for more than a year with no previous lung infections or surgery. Initially, a diagnostic computed tomography was made, showing a rare arterio-arterial malformation between the right inferior phrenic and right pulmonary artery leading into a vascular bundle in the middle lung lobe. Due to the patients ? dyspnea and massive extent of malformation, the indication for transcatheter arterial embolization was made. The first transcatheter arterial embolization procedure involved the inferior phrenic and a selective branch of the internal thoracic artery. Interventional angiography as well as computed tomography revealed further extend of the malformation showing a connection of right lateral thoracic, hepatic, and inferior epigastric artery to the fistula. After one month, a second transcatheter arterial embolization of these arteries as well as a second approach of the proximal internal thoracic artery was performed. In the follow-up the patient described a substantial improvement of her dyspnea and showed no signs of infections. A phrenic artery to pulmonary artery fistula is an extremely rare case occurring congenital or acquired. Patients may be asymptomatic or present, among others, dyspnea, hemoptysis, pulmonary infections and congestive heart failure. Symptomatic patients require treatment using transcatheter arterial embolization or surgical resection. The patient had dyspnea and a substantial extent of malformation with possibly complicated clinical course. The recommended less invasive treatment using transcatheter arterial embolization was successfully performed. In conclusion, our patient represented a rare congenital case of systemic and pulmonary artery communication, which we were able to treat sufficiently with coil embolization.

Role of Nicorandil effect on Contrast Induced Nephropathy in patients land for elective PCI

Background: Patients having percutaneous coronary intervention (PCI) and coronary angiography (CAG) are more likely to experience contrast-induced nephropathy (CIN), which is linked to higher mortality and morbidity (PCI). Our goal was to assess the effectiveness of nicorandil medication given to patients getting ready for elective PCI in reducing the occurrence of CIN.

Recent Review Article in RPT: Review and investigation of automatic brightness/dose rate control logic of fluoroscopic imaging systems in cardiovascular interventional angiography

Recent Review Article in RPT: Review and investigation of automatic brightness/dose rate control logic of fluoroscopic imaging systems in cardiovascular interventional angiography

Reduction of radiation dose using real‐time visual feedback dosimetry during angiographic interventions

This prospective study sought to evaluate potential savings of radiation dose to medical staff using real-time dosimetry coupled with visual radiation dose feedback during angiographic interventions. For this purpose, we analyzed a total of 214 angiographic examinations that consisted of chemoembolizations and several other types of therapeutic interventions. The Unfors RaySafe i2 dosimeter was worn by the interventionalist at chest height over the lead protection. A total of 110 interventions were performed with real-time radiation dosimetry allowing the interventionalist to react upon higher x-ray exposure and 104 examinations served as the comparative group without real-time radiation monitoring. By using the real-time display during interventions, the overall mean operator radiation dose decreased from 3.67 (IQR, 0.95-23.01) to 2.36μSv (IQR, 0.52-12.66) (-36%; p=0.032) at simultaneously reduced operator exposure time by 4.5min (p=0.071). Dividing interventions into chemoembolizations and other types of therapeutic interventions, radiation dose decreased from 1.31 (IQR, 0.46-3.62) to 0.95μSv (IQR, 0.53-3.11) and from 24.39 (IQR, 12.14-63.0) to 10.37μSv (IQR, 0.85-36.84), respectively, using live-screen dosimetry (p≤0.005). Radiation dose reductions were also observed for the participating assistants, indicating that they could also benefit from real-time visual feedback dosimetry during interventions (-30%; p=0.039). Integration of real-time dosimetry into clinical processes might be useful in reducing occupational radiation exposure time during angiographic interventions. The real-time visual feedback raised the awareness of interventionalists and their assistants to the potential danger of prolonged radiation exposure leading to the adoption of radiation-sparing practices. Therefore, it might create a safer environment for the medical staff by keeping the applied radiation exposure as low as possible.

REBOA in trauma and the risk of venous thromboembolic complications: A matched-cohort study

BackgroundResuscitative Endovascular Balloon Occlusion of the Aorta (REBOA) has been used as a damage control procedure in trauma patients. We hypothesized that REBOA increases risk of venous thromboembolic (VTE) complications. MethodsThis was an American College of Surgeons Trauma Quality Improvement Program (ACS-TQIP) database study. Excluded were transfers, deaths within 24 h, and severe head injuries. Included were trauma patients receiving REBOA within 4 h from arrival. Outcomes in the two groups were compared after using propensity score matching (PSM) for demographic and clinical characteristics, body area abbreviated injury scale, injury severity score, pelvis and lower extremity fractures, angiographic intervention, preperitoneal pelvic packing, pharmacological VTE prophylaxis, laparotomy, laparotomy and specific orthopedic procedures. ResultsAfter PSM, 339 REBOA patients were matched with 663 patients with No REBOA. REBOA patients were significantly more likely to develop pulmonary embolism (PE) (5.3% vs. 2.7%, p = .037) and VTE (14.7% vs. 10.0%, p = .025). ConclusionREBOA is associated with an increased risk of PE and VTE complications. Patients managed with REBOA should receive adequate thromboprophylaxis and be monitored closely for VTE complications.

Diagnostic aspects of multi-detector CT in detection of coronary arteries stenotic lesions diseases versus interventional Diagnostic Angiography

Diagnostic aspects of multi-detector CT in detection of coronary arteries stenotic lesions diseases versus interventional Diagnostic Angiography

A study on role of DSA in intracerebral vascular anomaly comparison with computed tomography angiography/magnetic resonance angiography

Background: Brain imaging techniques provide the ability to noninvasively map the structure and functions of the brain. Brain vascular malformation mainly affects people in the 5th decade followed by 4th and 3rd decade. Aims and Objectives: The aim of the study was to compare the diagnostic supremacy of computed tomography angiography (CTA)/magnetic resonance angiography (MRA) and Digital subtraction angiography (DSA) for the detection of intracranial vascular anomalies. Materials and Methods: An observational descriptive study with cross-sectional design was performed among 50 patients of both sexes undergoing DSA test at Medical College and Hospital, Kolkata with acute stroke syndrome or any other symptoms suggesting intracranial vascular lesion, who were investigated with one or more index tests and a reference standard diagnosed by computed tomography (CT) or MR scanning or other parameters. DSA served as the standard of reference for presence of intracranial vascular anomalies. Results: Out of the 50 patients included in the study, 41 were diagnosed with vascular malformations by DSA. Moya moya disease was diagnosed in three and distal AV fistula in six patients. In the 41 patients with vascular malformations, CTA could correctly identify 17 (41.5%) cases whereas MRA could identify 73.2% cases. Conclusion: DSA can be used for both diagnostic and interventional angiography. Its high spatial and temporal resolution have maintained DSA as a very important tool. The study reveal DSA is more superior to accurate angioarchitectural delineation of different intracerebral vascular malformation.

Pediatrik Anjiolar: Tek Merkez Deneyimi

Objective: Congenital heart disease is the most common congenital anomaly. Early diagnosis and timely intervention are important in congenital heart disease. The aim of this study to share our experience and follow-up results of diagnostic and interventional angiography procedures performed in our center.&#x0D; Materials and Methods: The retrospective study included patients who underwent catheter angiography in our clinic between July 2018 and October 2021. &#x0D; Results: This study included 47 children with a mean age of 5.7 (SD, 2.9) years (0-17 years) who underwent catheter angiography. 47% of study population was girls. Diagnostic catheter angiography was performed in 29 patients. Successful interventional catheter angiography was performed in 18 patients. No significant complications were observed during or after diagnostic and interventional catheter angiography.&#x0D; Conclusion: Diagnostic and interventional angiography procedures can be performed successfully in our clinic. In recent years, interventional angiography procedure has been preferred more because it shortens the hospital stay and does not create surgical scar tissue.

Interventional angiography utilization for adult trauma patients in Trauma Centers across the United States: An observational study using the National Trauma Data Bank.

Angiography and embolization are part of trauma management protocols for various injuries. This study examines the use of angiography and embolization use in trauma care across Trauma Centers in the United States.We used the National Trauma Data Bank (NTDB) 2017 dataset in this retrospective observational study. Adult trauma patients (≥16 years) who underwent conventional angiography with or without embolization were included. A univariate analysis was carried out to describe patients’ demographic and injury characteristics as well as the time to angiography, angiography details, complications, and outcome (survival to hospital discharge: yes/no). One-year period prevalence proportion of angiography procedure was determined.A total of 4242 patients were included. The 1-year period prevalence proportion of angiography procedure with or without embolization was 0.53% (95% confidence intervals: 0.527–0.529). The median age was 41 years (interquartile range: 27–58) with most patients being in the age group 16 to 64 (83.8%) and males (72.6%). Over half of the patients, 55.4% had an embolization procedure performed in addition to angiography. The mean time to angiography was 263.77 ± 750.19 minutes. The most common embolization sites were the pelvis (24.9%), spleen (11.8%), and liver (9%).This study described angiography and embolization utilization in adult trauma patients in Trauma Centers in the US. Its findings provide the basis for future studies to examine more closely angiography/embolization utilization in specific subpopulations, and to create standardized risk stratification tools for trauma patients who are candidates for this procedure.

Tumor thrombus formation in the right common iliac vein after radical proctectomy in a patient with rectal cancer: a case report

BackgroundIntravascular tumor thrombi are mainly found in patients with liver cancer or renal carcinoma but rarely occur in those with rectal cancer.Case presentationThis is a case report of a 58-year-old woman with a swollen right lower extremity 14 months after radical resection for rectal cancer. Although ultrasonography indicated the presence of deep venous thrombosis (DVT) located in the right common iliac vein, interventional angiography showed that a circular mass, considered a tumor thrombus, was located in the right common iliac vein. The tumor thrombus was cured by interventional therapy, and the pathological report confirmed that the metastatic tumor thrombus originated from the rectal cancer. The patient underwent concurrent chemoradiotherapy and systemic therapy. However, right lung, retroperitoneum, and 2nd sacral vertebral metastases were discovered during follow-up.ConclusionThe correct diagnosis of a tumor thrombus and its differentiation from DVT can prevent incorrect treatment and prolong the survival of patients with rectal cancer.

Occupational doses in interventional angiography after radiological protection training and use of a real-time direct display dosimeter

Vascular x-ray guided interventions are complex and may result in high occupational doses to ionising radiation if staff do not take appropriate actions to minimise their exposure. In this prospective intervention study, ten staff members wore an extra personal dosimeter on the upper body above their regular protective clothing during four consecutive periods. Between each period either additional practical radiological protection training was given or a real-time direct display dosimeter were provided to the staff. Each staff’s personal dose equivalent, Hp(10) normalised to the total air kerma-area product for the procedures where each staff were involved, KAPt, was used as the dependent variable. A focus-group interview with the staff were performed about the usefulness of the training and real-time dose rate display system. Our aim was to investigate if the interventions (practical training or real-time dose rate display) did affect the staff doses in the short and long term (five months later). Significant (p < 0.05) reductions of staff doses Hp(10)/KAPt were found after practical radiological protection training, but not after using real-time dose rate displays. Significant reductions were maintained after five months without additional interventions. The results from the focus-group interview indicated that making radiation ‘visible’, during practical training and usage of real-time direct display dosimeter, made it easier to understand how to act to lower occupational doses.

Objectively measured preoperative physical activity and sedentary behaviour among Finnish patients scheduled for elective cardiac procedures: baseline results from randomized controlled trial

BackgroundWe investigated preoperative physical activity (PA) and sedentary behaviour (SB) in patients scheduled for elective cardiac procedures and compared them with population-based sample of Finnish adults.MethodsCardiac patients (n = 139) undergoing cardiac operations carried a triaxial accelerometer for seven days during the month before the procedure. Patients were categorised into four groups according to the procedure: percutaneous coronary intervention or coronary angiography (PCI-CA), coronary artery bypass grafting (CABG), aortic valve replacement (AVR) and mitral valve surgery (MVS). The raw accelerometer data was analyzed with dedicated algorithms to determine metabolic equivalents (METs, 3.5 mL/kg/min of oxygen consumption) of PA. The intensity of PA was divided into two categories: light (LPA, 1.5–2.9 METs) and moderate-to-vigorous (MVPA, ≥ 3.0 METs), while SB represented intensity < 1.5 MET without movements. SB and PA were described as daily means and accumulation from different bout lengths. Daily standing, steps and mean and peak MET-values were calculated. The results were compared between the patient groups and against the reference group from a population-based study FinFit2017.ResultsCardiac patients had fewer daily steps than the FinFit population (p = 0.01), and less SB accumulating from < 20 min bouts (p = 0.002) but more from 20 to 60 min bouts (p = 0.002). Particularly, CABG group had less daily MVPA (p = 0.002) and MVPA accumulating from > 10 min bouts (p < 0.001) than the FinFit population.ConclusionsWe found large differences in PA and SB between the patient groups and the FitFit population, CABG group having the worst activity profile. Also, the variation within the patient groups was wide, which should be considered to individualise the rehabilitation programs postoperatively.Trial registration clinicaltrials.gov (NCT03470246). Registered 19 March 2018, https://clinicaltrials.gov/ct2/show/NCT03470246.