Università degli studi di Modena e Reggio Emilia

Università degli Studi di Modena e Reggio Emilia
Corso di laurea in infermieristica - Sede di Modena

Abstract

The aim of the research was to study the role of vascular approach (secondary) for percutaneous coronary intervention, peripheral and structural complexes. Were included all patients who had undergone the following percutaneous interventions and approaches that required two vascular CTO (total coronary occlusion) complex or the main trunk revascularization (PCI), TAVI (transcatheter aortic valve implantation), protection of visceral vessels during endovascular repair of aneurysm, lower limb angioplasty complex. For the purposes of this analysis were compared to the results of those patients who received a transradial approach against those who received a transfemoral/brachial approach. Primary endpoints of the study were procedural success and hemorrhage in the hospital with BARC 3/5 of the total, higher than the one in transradial (both approaches primary and secondary). In the retrospective study were included 867 patients, 419 treated with radial approach left/right and 448 with the femoral /brachial approach of  nine cath labs Italian and one in the Netherlands. Patients underwent the following types of interventions: coronary CTO, the other PCI complex, TAVI, EVAR/TEVAR. Procedural success was achieved in 90% of the group with radial access and 92% with transfemoral/brachial approach. In group transfemoral/brachial was also observed a greater decrease in hemoglobin and length of hospital stay longer, while the use of the approach transradial the amount of contrast medium and the procedural time were significantly higher. In conclusion, the transradial approach, significantly reduces the risk of major bleeding, without compromising the success of percutaneous coronary intervention, or peripheral structural complexes.