Liječnički vjesnik, Vol. 134 No. 5-6, 2012.
Ostalo
TRANSRADIAL APPROACH IN INTERVENTIONAL CARDIOLOGY: »QUOD LICET FEMORALISTI, NON LICET RADIALISTI«
Josip Lukenda
Sažetak
Transradial approach has been used in invasive cardiology since 1989 and since 1995 for PCI. Croatia is late in using this technique for about one whole decade. The advantage of transradial approach over femoral approach are serious local complications of (2.6–2.8%), more frequent with modern therapy (7.4%), occasionally requiring surgical repair (2.4%). Major adverse cardiovascular events are significantly more occurring with femoral (3.8–6.55%) compared to transradial approach (2.5–3.7%), while in the MORTAL study total mortality is higher as well. Patients prefer transradial approach due to it being less painful and uncomfortable, and also because of greater mobility after the procedure. Time spent for patient care by nurses is shortened by half than what it used to be, and the final savings per patient is $290. An unfavorable aspect of transradial approach is clinically insignificant radial artery occlusion (0.6%–1.4%), as well as higher radiation exposure, for 12% in practice. Procedural time is similar, but it could take up to 3 minutes longer. Access site crossover is more often with transradial (4.7–7.6%), compared to femoral procedure (1.4–2.0%), but PCI failure is independent of approach. All unfavorable aspects are diminishing with experience of a cardiologist. Now, some of the Croatian centers, such as General Hospital Zadar, use transradial approach in 67% of catheterizations, 64% of PCI, and 38% of all primary PCIs.
Ključne riječi
Coronary disease – therapy; Angioplasty, balloon, coronary – methods, adverse effects; Catheterization, peripheral – methods, adverse effects; Femoral artery; Radial artery
Hrčak ID:
172428
URI
Datum izdavanja:
25.6.2012.
Posjeta: 1.085 *