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2012, Number 2

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Invest Medicoquir 2012; 4 (2)

Ambulatory coronary intervention by brachial access in CIMEQ

Conde CH, Obregón SÁG, Aroche AR, Aldama PL, Padrón PR

Language: Spanish
References: 40
Page: 146-162
PDF size: 128.13 Kb.


ABSTRACT

Introduction. Ischemic cardiopathy is the first cause of morbidity and mortali ty in Cuba and other countries. The most extended treatment is coronariography and angioplasty Methods. A prospective, no controlled study was conducted from 2004 and 2008. 152 patients were enrolled who made outpatients coronariography and were implanted coronary stents (160 lessons) by angioplasty with optimal results. Results. Found 73, 9% of male, stable angina 52, 2%, mean age 57,7 years. Hypertension was the most frequent risk factor. 81, 6% receive 300 mg of clopidogrel during or immediately after procedure. Left anterior descending artery was most frequently treated and B2 type lessons. The mid time procedure was 35, 5 minutes. Pre -procedure reference diameter 2,9 + 0.4 mm, post-procedure 3,1 ± 0,4 mm; length lesson 15,4 + 4,3 mm. 2,6% of minor vascular complications. 95% free adverse event survivor. Diffuse pattern associated to total occlusion of angiographic restenosis 4, 4%. Conclusions. Brachial cut dawn ambulatory angioplasty stent in selected patients with optimal angiography results is feasible and safe.


REFERENCES

  1. 1 Ellis SG, Roubin GS, King SB, Douglas JS Jr, Shaw RE, Stertzer SH, et al. In -hospital cardiac mortality after acute closure after coronary angioplasty: Analysis of risk factors from 8,207 procedures. J Am Coll Cardiol.1988;11:211 -15.

  2. 2 Roubin GS. History of cardiovascular Intervention En: Gary S. R. Editor. Interventional Cardiovascular Medicine New York: Churchill Livingstone 1994:4 -12.

  3. 3 Spaulding C, Daemen J, Boersma E, Cutlip DE, Serruys PW. A pooled analysis of data comparing sirolimus-eluting stents with bare-metal stents. N Engl J Med. 2007;356:981 -4.

  4. 4 Bainey KR, Norris CM, Graham MM, Ghali WA, Knudtson ML, Welsh RC.. Clinical in -stent restenosiswith bare metal stents: is it truly a benign phenomenon? Int J Cardiol. 2008;128:378 -82.

  5. 5 Labriolle A, Bonello L, Lemesle G, Steinberg DH, Roy P, Xue Z, et al. Clinical presentation and outcome of patients hospitalized for symptomatic in -stent restenosis treated by percutaneous coronary intervention: comparison between drug -eluting stents and bare -metal stents. Arch Cardiovasc Dis. 2009;102:209 -17.

  6. 6 Sousa JE, Costa MA, Abizaid A, Abizaid AS, Feres F, Pinto IM, et al. Lack of neointimal proliferation after implantation of sirolimus coated stents in human coronary arteries: a quantitative coronary angiography and three -dimensional intravascular ultrasound study. Circulation. 2001;103:192 -5.

  7. 7 Serruys PW, Morice MC, Kappetein AP, Colombo A, Holmes DR, Mack MJ, et al. Percutaneous Coronary Intervention versus Coronary -Artery Bypass Grafting for Severe C oronary Artery Disease. N Engl J Med. 2009;360:961 -72.

  8. 8 Feyter PJ d, Brand M, Laarman GJ, Domburg R, Serruys PW, Suryapranata H, et al. Acute coronary artery occlusion during and after percutaneous transluminal coronary angioplasty. Frequency, prediction, clinical course, management and follow up. Circulation. 1999;83:927 -36.

  9. 9 Webber GW, Jang J, Gustavson S, Olin JW. Contemporary management of postcatheterization pseudoaneurysms. Circulation. 2007;115:2666 -74.

  10. 10 Kiemeneij F, Laarman GJ, Odekerken D, Slag boom T, Wieken R. A randomized comparison of percutaneous transluminal coronary angioplasty by the radial, brachial and femoral approaches: the access study. J Am Coll Cardiol. 1997;29:1269 -75.

  11. 11 Bertrand OF, Larose E, Larochellière R, Proulx G, Nguyen CM , Déry JP, et al. Outpatient percutaneous coronary intervention: Ready for prime time? Can J Cardiol. 2009;25:140 -45.

  12. 12 Laarman GJ, Kiemeneij F, Wieken LR, Tijssen JG, Suwarganda JS, Slagboom T. A pilot study ofcoronary angioplasty in outpatients. Br Heart J. 1994;72:12 -15.

  13. 13 Wilentz JR, Mishkel G, McDermott D, Ravi K, Fox JT, Reimers CD, et al. Outpatient coronary stenting: femoral approach with vascular sealing. J Invasive Cardiol. 1999;11:709-17.

  14. 14 Slagboom T, Kiemeneij F, Laarman GJ, Wieken R, Odeke rken D. Actual outpatient PTCA: results of the OUTCLASS pilot study. Catheter Cardiovasc Interv. 2001;53:204 -8.

  15. 15 Clement-Major S, Lemire F. Is outpatient coronary angioplasty and stenting feasible and safe? Results of a retrospective analysis. Can J Card iol. 2003;19:47-50.

  16. 16 Sones FM. Coronary arteriography read before the Eight Annual Convention of the American Collage of Cardiology, Philadelphia 1959.p.321 -28.

  17. 17 Conde H, Obregón AG, Aroche R, Domínguez RJ. Intervencionismo coronario por disección de l a arteria braquial derecha. Invest Medicoquir. 2007;2(1):13 -8.

  18. 18 Ellis SG, Vandormael MG, Cowley MJ, DiSciascio G, Deligonul U, Topol EJ, et al. Coronary morphology and clinical determinant s of procedural outcome with angioplasty for multivessel coronary disease: Implications for patient selection. Circulation. 1990;82:1193 -202.

  19. 19 Sousa AGMR, Abizaid A, Matínez M, Berrocal D, Sousa JE, editores. Intervenciones cardiovasculares SOLACI. –2ª ed. — Bogotá: Distribiuna 2009.p.214 -19.

  20. 20 Mehran R, Dangas G, A bizaid AS, Mintz GS, Lansky AJ, Satler LF, et al. Angiographic patterns of in-stent restenosis: classification and implication for long -term outcome. Circulation. 1999;100:1872 -8.

  21. 21 Heyde GS, Koch KT, Winter RJ, Dijkgraaf MG, Klees MI, Dijksman LM, et al. Randomized trial comparing same-day discharge with overnight hospital stay after percutaneous coronary intervention: results of the Elective PCI in Outpatient Study (EPOS).Circulation. 2007;115:2299 -306.

  22. 22 Spinler SA. Percutaneous coronary intervention; assessing coronary vascular risk associated with bare-metal and drug-eluting stents. Am J Manag Care. 2009;15:42 -7.

  23. 23 Ziakas AA, Klinke BP, Mildenberger CR, Fretz DE, Williams EM, Kinloch FR, et al. Safety of sameday- discharge radial percutaneous coronar y intervention: a retrospective study. Am Heart J. 2003;146:699-704.

  24. 24 Small A, Klinke P, Della Siega A, Fretz E, Kinloch D, Mildenberger R, et al. Day procedure intervention is safe and complication free in higher risk patients undergoing transradial ang ioplasty and stenting. The discharge study. Catheter Cardiovasc Interv. 2007;70:913 -17.

  25. 25 Moushmoush B, Kramer B, Hsieh AM, Klein LW. Does the AHA/ACC task force grading system predict outcome in multivessel coronary angioplasty? Cathet Cardiovasc Diagn. 1992;27:97-105.

  26. 26 Widimský P, Motovská Z, Šimek S, Kala P, Pudil R, Holm F, et al. On behalf of the PRAGUE -8 trial Investigators. Clopidogrel pre -treatment in stable angina: for all patients >6 h before elective coronary angiography or only for angiograph ically selected patients a few minutes before PCI? A randomized multicenter trial PRAGUE -8. Eur Heart J. 2008;29:1495 -03.

  27. 27 Mangin L, Bertrand OF, Rochellière R, Proulx G, Lemay R, Barbeau G, et al. The transulnar approach for coronary intervention: a saf e alternative to transradial approach in selected patients. J Invasive Cardiol. 2005;17:77 -9.

  28. 28 Khater M, Zureikat H, Alqasem A, Alnaber N, Alhaddad IA. Contemporary outpatient percutaneous coronary intervention: feasible and safe. Coron Artery Dis. 2007; 18:565-9.

  29. 29 Wiper A, Kumar S, MacDonald J, Roberts DH. Day case transradial coronary angioplasty: A four - year single-center experience. Catheter Cardiovasc Interv. 2006;68:549 -53.

  30. 30 Miketic S, Carlsson J, Tebbe U. Clinical and angiographic outcome after conventional angioplasty with optional stent implantation compared with direct stenting without predilatation. Heart. 2002;88:622-6.

  31. 31 Pana M, Suárez de Lezo J, Romero M, Segura J, Pavlovic D, Ojeda S, et al. Intervencionismo percutáneo. ¿Dónde estamos y a dónde vamos? Rev Esp Cardiol. 2005;58:290-300.

  32. 32 Spencer B, King III, Sidney C, Smith Jr, John W, Hirshfeld Jr, et al. 2007 Focused Update of the ACC/AHA/SCAI 2005 Guideline Update for Percutaneous Coronary Intervention. Circulation. 2008;117:261-95.

  33. 33 Aroche R, Obregón AG, Conde H, Hernández M, Calderón W, Rodríguez AY. Reestenosis post implante de stent coronario metálico convencional. Invest Medicoquir. 2007;2(1):32-7.

  34. 34 Hannan EL, Racz MJ, Arani DT, Mc Callister BD, Walford G, Ryan TJ. A compariso n of short and long-term outcomes of for balloon angioplasty and coronary stent placement. J Am Coll Cardiol. 2000;36:395-403.

  35. 35 Kiemeneij F, Laarman GJ, Slagboom T, Wieken R. Outpatient coronary stent implantation. J Am Coll Cardiol.1997;29:323 -7.

  36. 36 David JR, Hildick-Smith MD, Zafar IK, Leonard M, Shapiro MC, Petch ND, et al. Occasional - operator percutaneous brachial coronary angiography: First, do not arm. Cathet Cardiovasc Intervent. 2002;57:161 -5.

  37. 37 Mauri L, Silbaugh TS, Wolf RE, Zelevinsky K, Lovett A, Zhou Z, et al. Long -term clinical outcomes after drug-eluting and bare-metal stenting in Massachusetts. Circulation. 2008;118:1783 -4.

  38. 38 Vavalle JP, Rao SV. The association between the transradial approach for percutaneous coronary interventions and b leeding. J Invasive Cardiol. 2009;21:21A -24A.

  39. 39 Lemos PA, Martínez EE, Quintella E, Harrell LC, Ramirez JA, Ribeiro E, et al. Stenting versus balloon angioplasty with provisional stenting for the treatment of vessels with small reference diameter. Cathet Cardiovasc Intervent. 2002;55:309 -14.

  40. 40 Goldberg SL, Loussararian A, Gregorio J, Di Mario C, Albiero R, Colombo A. Predictors of diffuse and aggressive intrastent restenosis. J Am Coll Cardiol. 2001;37:1019 -25.




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