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Radial access

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https://www.readbyqxmd.com/read/28528767/acute-kidney-injury-after-radial-or-femoral-access-for-invasive-acute-coronary-syndrome-management-aki-matrix
#1
Giuseppe Andò, Bernardo Cortese, Filippo Russo, Martina Rothenbühler, Enrico Frigoli, Giuseppe Gargiulo, Carlo Briguori, Pascal Vranckx, Sergio Leonardi, Vincenzo Guiducci, Flavia Belloni, Fabio Ferrari, Jose Maria de la Torre Hernandez, Salvatore Curello, Francesco Liistro, Andrea Perkan, Stefano De Servi, Gavino Casu, Antonio Dellavalle, Dionigi Fischetti, Antonio Micari, Bruno Loi, Fabio Mangiacapra, Nunzio Russo, Fabio Tarantino, Francesco Saia, Dik Heg, Stephan Windecker, Peter Jüni, Marco Valgimigli
BACKGROUND: It remains unclear whether radial access (RA), compared with femoral access (FA), mitigates the risk of acute kidney injury (AKI). OBJECTIVES: The authors assessed the incidence of AKI in patients with acute coronary syndrome (ACS) enrolled in the MATRIX-Access (Minimizing Adverse Haemorrhagic Events by Transradial Access Site and Systemic Implementation of Angiox) trial. METHODS: Among 8,404 patients, 194 (2.3%) were excluded due to missing creatinine values, no or an incomplete coronary angiogram, or previous dialysis...
May 11, 2017: Journal of the American College of Cardiology
https://www.readbyqxmd.com/read/28527778/outcomes-in-patients-undergoing-primary%C3%A2-percutaneous-coronary-intervention-for-st-segment-elevation-myocardial-infarction-via-radial-access-anticoagulated-with-bivalirudin-versus%C3%A2-heparin-a-report-from-the-national-cardiovascular-data-registry
#2
Ion S Jovin, Rachit M Shah, Dhavalkumar B Patel, Sunil V Rao, Dmitri V Baklanov, Issam Moussa, Kevin F Kennedy, Eric A Secemsky, Robert W Yeh, Michael C Kontos, George W Vetrovec
OBJECTIVES: The aim of this study was to compare bivalirudin with heparin as anticoagulant agents in patients with ST-segment elevation myocardial infarction treated with radial primary percutaneous coronary intervention (PCI). BACKGROUND: Recent studies in which PCI was performed predominantly via radial access did not show bivalirudin to be superior to heparin. METHODS: Outcomes were compared in patients with STEMI included in the National Cardiovascular Data Registry CathPCI database from 2009 to 2015 who underwent primary PCI via radial access and who were anticoagulated with bivalirudin or heparin...
May 11, 2017: JACC. Cardiovascular Interventions
https://www.readbyqxmd.com/read/28525886/relationship-between-arterial-access-and-outcomes-in-st-elevation-myocardial-infarction-with-a-pharmacoinvasive-versus-primary-percutaneous-coronary-intervention-strategy-insights-from-the-strategic-reperfusion-early-after-myocardial-infarction-stream-study
#3
Jay Shavadia, Robert Welsh, Anthony Gershlick, Yinggan Zheng, Kurt Huber, Sigrun Halvorsen, Phillipe G Steg, Frans Van de Werf, Paul W Armstrong
BACKGROUND: The effectiveness of radial access (RA) in ST-elevation myocardial infarction (STEMI) has been predominantly established in primary percutaneous coronary intervention (pPCI) with limited exploration of this issue in the early postfibrinolytic patient. The purpose of this study was to compare the effectiveness and safety of RA versus femoral (FA) access in STEMI undergoing either a pharmacoinvasive (PI) strategy or pPCI. METHODS AND RESULTS: Within STrategic Reperfusion Early After Myocardial Infarction (STREAM), we evaluated the relationship between arterial access site and primary outcome (30-day composite of death, shock, congestive heart failure, or reinfarction) and major bleeding according to the treatment strategy received...
June 13, 2016: Journal of the American Heart Association
https://www.readbyqxmd.com/read/28523028/peripheral-arterial-blood-pressure-versus-central-crterial-blood-pressure-monitoring-in-critically-ill-patients-after-cardio-pulmonary-bypass
#4
Rana Altaf Ahmad, Suhail Ahmad, Anjum Naveed, Mirza Ahmad Raza Baig
OBJECTIVE: To determine the accuracy of peripheral (radial) arterial access as compared to central (femoral) arterial access for measurement of invasive blood pressure (IBP) in critically ill patients after cardiopulmonary bypass. METHODS: Sixty patients (60) who required high inotropic/vasopressor support on weaning from cardio-pulmonary bypass and weaned off in 2(nd) attempt were included in this study. The duration of this study was from June 2015 to August 2016...
March 2017: Pakistan Journal of Medical Sciences Quarterly
https://www.readbyqxmd.com/read/28521353/intraoperative-angiography-for-arteriovenous-malformation-resection-in-the-prone-and-lateral-positions-using-upper-extremity-arterial-access
#5
Erez Nossek, David J Chalif, Razvan Buciuc, Eric J Gandras, Erich G Anderer, Sal Insigna, Amir R Dehdashti, Avi Setton
BACKGROUND: Intraoperative angiography is routinely utilized for aneurysms and arteriovenous malformations (AVMs) to verify complete occlusion and resection. Surgery for spinal and posterior fossa neurovascular lesions is usually performed in prone position. Intraoperative angiography in the prone position is challenging and there is no standardized protocol for this procedure. OBJECTIVE: To describe our experience with intraoperative angiography in the prone and lateral positions, using upper extremity arterial access...
June 1, 2017: Operative Neurosurgery (Hagerstown, Md.)
https://www.readbyqxmd.com/read/28515857/contrast-use-in-relation-to-the-arterial-access-site-for-percutaneous-coronary-intervention-a-comprehensive-meta-analysis-of-randomized-trials
#6
Rahman Shah, Anthony Mattox, M Rehan Khan, Chalak Berzingi, Abdul Rashid
AIM: To compare the amount of contrast used during percutaneous coronary intervention (PCI) via trans-radial access (TRA) vs trans-femoral access (TFA). METHODS: Scientific databases and websites were searched for:randomizedcontrolledtrials (RCTs). Data were extracted by two independent reviewers and was summarized as the weighted mean difference (WMD) of contrast used with a 95%CI using a random-effects model. RESULTS: The meta-analysis included 13 RCTs with a total of 3165 patients...
April 26, 2017: World Journal of Cardiology
https://www.readbyqxmd.com/read/28506941/left-distal-transradial-access-in-the-anatomical-snuffbox-for-coronary-angiography-ldtra-and-interventions-ldtri
#7
Ferdinand Kiemeneij
AIMS: To demonstrate the feasibility of distal left transradial approach for patients in whom left radial access is preferred over right radial access for coronary angiography and interventions. This procedure is more convenient for the operator. For the right- handed patient, left radial access is more convenient because of the free use of the right hand after the procedure. In addition, this technique reduces the chance for radial artery occlusion at the site of the distal forearm. METHODS AND RESULTS: Coronary access via the left distal radial artery at the anatomical snuffbox allows comfortable positioning of the dorsal side of the patient's left hand near the right groin...
May 16, 2017: EuroIntervention
https://www.readbyqxmd.com/read/28506579/-initial-management-of-st-elevation-myocardial-infarction-in-2014-from-guidelines-to-practices-survey-of-176-french-interventional-cardiologists
#8
E Capilla, R Poyet, A-V Tortat, F-X Brocq, F Pons, S Kerebel, C Jego, G R Cellarier
BACKGROUND: Real life management of myocardial infarction has not recently been evaluated in France. AIMS: To describe ST-elevation myocardial infarction management in France in 2014 and to compare it with current guidelines. METHODS: A multicentre study was performed. An e-mail questionnaire was sent to French interventional cardiologists. Demographic data of interventional cardiologists, procedural aspects of percutaneous coronary intervention, antithrombotic treatments and patient rehabilitation have been investigated...
May 12, 2017: Annales de Cardiologie et D'angéiologie
https://www.readbyqxmd.com/read/28504234/spain-coronary-and-structural-heart-interventions-from-2010-to-2015
#9
Bruno García Del Blanco, Pilar Jiménez Quevedo, José D Diaz, Felipe Hernández, José Ramón Rumoroso, Manel Sabaté, José Maria de la Torre Hernandez, Ana Serrador, Armando Pérez de Prado, Javier Goicolea, Ramiro Trillo, Manolo Pan
Since 1990 The Spanish Society of Cardiology Working Group on Cardiac Catheterization and Interventional Cardiology has presented a yearly report on the data collected in the National Registry, with online support since 2010. The Steering Committee has analysed all data provided voluntarily by institutions, which consisted of a total of anywhere between 105 and 113 hospitals. Medical care was provided to a population of 46.8 million inhabitants in 2015. During this period, diagnostic procedures increased progressively from 2010, reaching a maximum of 145,836 in 2015, 86% (125,484) corresponding to coronary angiograms...
May 15, 2017: EuroIntervention
https://www.readbyqxmd.com/read/28504232/portugal-coronary-and-structural-heart-interventions-from-2010-to-2015
#10
Rui Campante Teles, Gustavo Pires-Morais, Pedro Canas da Silva, Rui Cruz Ferreira, Manuel de Sousa Almeida, Filipe Seixo, Marco Costa, Vasco Gama Ribeiro, Jorge Marques, João Carlos Silva, Hélder Pereira, Pedro Farto E Abreu, Henrique Carvalho, Eduardo Infante de Oliveira
The aim of the present paper is to report trends in Portuguese interventional cardiology from 2010 to 2015. We studied data from the prospective multicentre Portuguese National Registry of Interventional Cardiology (RNCI) to analyse percutaneous coronary intervention (PCI) procedures and structural heart interventions from 2010 to 2015. A total of 73,977 PCIs and 780 transcatheter aortic valve implants were performed during the study period. Since 2010 there has been a 60% increase in PCI procedures and a twofold increase in primary angioplasty rates reaching 316 per million population...
May 15, 2017: EuroIntervention
https://www.readbyqxmd.com/read/28504231/poland-coronary-and-structural-heart-interventions-from-2010-to-2015
#11
Jacek Legutko, Zbigniew Siudak, Radosław Parma, Andrzej Ochała, Dariusz Dudek
For the last five years, invasive cardiology in Poland has developed extensively. Currently, 98% of the 161 Polish cathlabs operate in 24/7 mode, 37 of them supported by cardiac surgery departments on-site. A certification curriculum for interventional cardiology operators is supported by dedicated workshops and scientific meetings during national conferences. The rise in the number of coronary angiographies and PCIs was paralleled by an increased use of drug-eluting stents, bioresorbable vascular scaffolds and physiologic assessment of coronary arteries...
May 15, 2017: EuroIntervention
https://www.readbyqxmd.com/read/28504228/italy-coronary-and-structural-heart-interventions-from-2010-to-2015
#12
Sergio Berti, Ferdinando Varbella, Alfredo Marchese, Luigi Emilio Pastormerlo, Giuseppe Musumeci
The aim of this report is to analyse trends in Italian cathlab activity between 2010 and 2015. Data were obtained from the national database of the Italian Society of Interventional Cardiology (GISE), which includes 97% of Italian cardiac catheterisation laboratories. The number of percutaneous coronary interventions (PCI) has remained relatively stable in the past five years. We have observed a significant increase in the number of primary PCI (pPCI) from 471.5 to 557.5 per million inhabitants with a consequent reduction of rescue primary PCI/fibrinolysis...
May 15, 2017: EuroIntervention
https://www.readbyqxmd.com/read/28504223/belgium-coronary-and-structural-heart-interventions-from-2010-to-2015
#13
Walter Desmet, Adel Aminian, Joëlle Kefer, Joseph Dens, Johan Bosmans, Marc Claeys, Christophe Dubois, Olivier Gach, Luc Janssens, Erwin Schroeder, Paul Vermeersch, Marc Carlier, Edouard Benit, Claude Hanet
In a ranking of the gross domestic product per capita in 2015, Belgium ranked 19th in the world according to the International Monetary Fun1d and the World Bank. It has a Human Development Index of 0.890, in which it is preceded by only 20 other countries in the world. This is, at least in part, due to a well-developed social security system on which all citizens can rely. Over the last 5-10 years, however, this system has come under increasing pressure. This has resulted in insufficient, incomplete and late reimbursement of all technologies that were introduced over the last ten years in the cathlab: intracoronary imaging techniques are not reimbursed at all, and FFR only to a vastly insufficient degree...
May 15, 2017: EuroIntervention
https://www.readbyqxmd.com/read/28495572/a-tumor-ultrasound-guided-incision-tugi-approach-to-nipple-sparing-mastectomy-balancing-oncologic-safety-and-technical%C3%A2-outcomes
#14
Emil J Fernando, Benjamin R Eskenazi, Risal S Djohan, Stephen R Grobmyer
BACKGROUND: Nipple-sparing mastectomy (NSM) is a prevalent operation for patients with breast cancer. Indications have been limited to tumors accessible via radial, infra-mammary, or periareolar incisions out of concern for oncologic and technical safety. We study an alternative approach to NSM based on tumor ultrasound-guided incisions (TUGI) and report its oncologic and technical outcomes. MATERIALS AND METHODS: A retrospective chart review examined patients who underwent TUGI NSM between 2013 and 2016...
April 12, 2017: Clinical Breast Cancer
https://www.readbyqxmd.com/read/28495430/patient-versus-physician-variation-in-use-of-transradial-percutaneous-coronary-intervention
#15
Shariq Shamim, Fengming Tang, David Safley, Philip Jones, John A Spertus, Dmitri Baklanov
The prevalence of radial access for transradial catheterization remains low in the United States, occurring in only 28% of cases in the National Cardiovascular Data Registry (NCDR) CathPCI. It is unknown whether the low adoption rate has been influenced by patient characteristics or is more operator dependent. In a 10-center study, we compared clinical and demographic characteristics among 323 radial and 1,506 femoral access percutaneous coronary intervention (PCIs) performed by 65 interventionists capable of radial PCI...
March 30, 2017: American Journal of Cardiology
https://www.readbyqxmd.com/read/28491081/safety-and-efficacy-of-transradial-coronary-angiography-and-intervention-in-patients-older-than-80-years-from-the-korean-transradial-intervention-prospective-registry
#16
Hoyoun Won, Wang Soo Lee, Sang-Wook Kim, Byung Ryul Cho, Young Jin Youn, Young-Hyo Lim, Min-Ho Lee, Jae-Hwan Lee, Seung-Woon Rha
BACKGROUND: Radial artery access for coronary procedures is a safe and beneficial technique. However, elderly patients have been considered as a higher risk group of access site related complications compared to younger patients. This study was conducted to investigate the feasibility and safety of transradial coronary angiography or intervention in the elderly. METHODS: A total of 6132 patients from Korean Transradial Intervention Prospective Registry at 20 centers were analyzed...
February 2017: Journal of Geriatric Cardiology: JGC
https://www.readbyqxmd.com/read/28490313/radial-vs-femoral-approach-in-acute-coronary-syndromes-a-comprehensive-meta-analysis-of-randomized-trials
#17
Matteo Nardin, Monica Verdoia, Lucia Barbieri, Alon Schaffer, Harry Suryapranata, Giuseppe De Luca
BACKGROUND: Substantial improvements have been achieved with percutaneous coronary intervention (PCI) for the treatment of acute coronary syndromes (ACS). Nevertheless, bleeding still affects outcomes. The radial approach for PCI has shown important benefits on access site complications, but is still not achieving universal consensus as first choice in acute settings. Therefore, we performed a comprehensive meta-analysis of randomized trials comparing radial vs femoral approach in PCI for ACS...
May 4, 2017: Current Vascular Pharmacology
https://www.readbyqxmd.com/read/28488412/revisiting-femoral-vs-radial-access-do-vascular-closure-devices-level-the-playing-field
#18
EDITORIAL
Tilak K R Pasala, Zoltan G Turi
Previous large randomized multicenter trials have shown superiority of radial to femoral access in reducing major bleeding, vascular complications, and in some cohorts, mortality Vascular closure devices improve time to hemostasis and ambulation, as well as patient comfort, but have not been shown to reduce major complications or mortality consistently in the high level evidence base. The combination of optimal femoral access and closure with a vascular closure device has the potential to narrow the gap between the radial and femoral approaches in high risk patients, but unfortunately this study was too limited to confirm either non-inferiority or equivalence...
May 2017: Catheterization and Cardiovascular Interventions
https://www.readbyqxmd.com/read/28488409/thin-walled-access-sheath-to-hold-a-larger-guide-new-technology-specifically-for-transradial-access
#19
EDITORIAL
Rhian E Davies, Ian C Gilchrist
Vascular access sheaths are now available with thin walls specifically designed for transradial use. A thin-walled sheath with an outside diameter on the same order of size as a 6-F traditional sheath can carry a 7-F guiding catheter. While the larger-sized guides may increase the interventional options for the radial operator, a hazard from vascular damage due to the larger-sized lumens may exist and points to a need for further improvement in radial specific equipment.
May 2017: Catheterization and Cardiovascular Interventions
https://www.readbyqxmd.com/read/28487035/radial-versus-femoral-access-for-the-treatment-of-left%C3%A2-main-lesion-in-the-era-of-second-generation-drug-eluting-stents
#20
Sebastiano Gili, Fabrizio D'Ascenzo, Roberto Di Summa, Federico Conrotto, Enrico Cerrato, Alaide Chieffo, Giacomo Boccuzzi, Antonio Montefusco, Fabrizio Ugo, Pierluigi Omedé, Hiroyoshi Kawamoto, Francesco Tomassini, Marco Pavani, Ferdinando Varbella, Roberto Garbo, Maurizio D'Amico, Giuseppe Biondi Zoccai, Claudio Moretti, Javier Escaned, Antonio Colombo, Fiorenzo Gaita
Transradial access (TRA) is often avoided in favor of the transfemoral access (TFA) during percutaneous coronary interventions of the unprotected left main coronary artery (ULM), due to technical and safety concerns. The aim of this study was to compare the performance of TRA and TFA in the treatment of ULM with second-generation drug-eluting stents. Consecutive patients who underwent percutaneous coronary intervention on ULM with second-generation drug-eluting stents were retrospectively enrolled in the multicenter Failure in Left Main Study With 2nd Generation Stents (FAILS 2) registry...
April 12, 2017: American Journal of Cardiology
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