Abstract 203: Evaluation of Acute Radial Artery Injury Following Transradial Percutaneous Coronary Intervention by Optical Coherence Tomography

2012 ◽  
Vol 5 (suppl_1) ◽  
Author(s):  
Vinay Arora ◽  
Anupama Shivaraju ◽  
Mladen Vidovich ◽  
Adhir Shroff
Keyword(s):  
Optical Coherence Tomography ◽  
Percutaneous Coronary Intervention ◽  
Radial Artery ◽  
Coronary Intervention ◽  
Cross Sectional Area ◽  
Sectional Area ◽  
Cross Sectional ◽  
Artery Injury ◽  
Percutaneous Coronary ◽  
Transradial Pci

Background: Recent evidence has shown a reduced bleeding risk and resultant decreased morbidity and mortality when the transradial approach is utilized over the transfemoral approach for percutaneous coronary intervention (PCI). However, transradial catheterization may introduce acute and/or chronic injury to the radial artery limiting its use for future procedures and as a bypass conduit. Our goal was to utilize optical coherence tomography (OCT) to evaluate the incidence of acute radial artery injury in patients following transradial PCI. Methods: In this observational study OCT (C7 Dragonfly catheter, St. Jude Medical Systems, St. Paul, MN) was used to evaluate the radial artery of 25 patients at the University of Illinois and Jesse Brown Veterans Affairs Medical Centers in Chicago, IL following transradial PCI. Specific injuries assessed for included radial artery dissection and thrombus formation. Diameter and cross sectional area of the artery were taken proximally and distally. Measurements were taken independently by two separate readers to account for inter-reader variability. Results: The radial artery was assessed in 25 patients following transradial PCI. The mean BMI of our patient population was 27.8 kg/m2. A 5Fr sheath was used in 24% (n=6) cases and a 6Fr sheath was utilized for the remaining 19 cases. In 8 cases the sheath was upsized from a 5 to 6 F. The average length of artery scanned was 39.4mm with a mean proximal cross sectional area of 7.56 mm2 and distal area of 7.08 mm2. An average of 4.4 catheter exchanges were made per case. A small intimal tear was noted in the radial artery of one patient. No other dissections or thrombi were noted. Conclusion: Based on our initial observation, the incidence of acute radial artery injury following transradial PCI is very low (1/25) and overall transradial PCI is a safe modality. When compared with prior studies we believe the factors that decreased the incidence of acute radial artery injury in our population were related to larger arterial cross sectional area, higher mean BMI, and ultimately a lower sheath size to artery diameter ratio.

A NEW METHOD TO STUDY ATHEROSCLEROSIS AND ASSESS THE EFFECTIVENESS OF PERCUTANEOUS CORONARY INTERVENTION BY COMPUTATIONAL FLUID DYNAMICS SIMULATION

2017 ◽  
Vol 17 (02) ◽  
pp. 1750035
Author(s):  
CHANGNONG PENG ◽  
PENGCHENG XU ◽  
ZHANCHAO XIAN ◽  
XIAOQING WANG ◽  
WENHUA HUANG ◽  
...  
Keyword(s):  
Fluid Dynamics ◽  
Computational Fluid Dynamics ◽  
Percutaneous Coronary Intervention ◽  
Coronary Intervention ◽  
Functional Evaluation ◽  
Sectional Area ◽  
Area Formula ◽  
High Quality ◽  
Cross Sectional ◽  
Percutaneous Coronary

High-pitch spiral computed tomography coronary angiography (CTCA) is able to perform a whole-heart scan within one heartbeat, resulting in high-quality images with high spatial and temporal resolution. To investigate the performance of high-quality CTCA images, an anatomic stenosis evaluation by digital subtracted angiography (DSA) was compared to a functional stenosis evaluation by CTCA-derived fraction flow reserve (FFR). A total of 54 arterial segments with stenosis were collected from 23 patients, and three-dimensional (3D) geometrical models were reconstructed. The computational fluid dynamics (CFDs) analysis was used to calculate the pressure distributions and FFR values. The correlation between anatomic and functional evaluation factors was assessed with either the ratio of anatomic reduction or CTCA-derived FFR values at the corresponding anatomic locations. Pearson correlation analysis was performed, and a significant correlation was found relating to the diameter ([Formula: see text]) and the cross-sectional area ([Formula: see text]). A significant correlation was also found in the functional evaluation relating to the diameter ([Formula: see text]) and the cross-sectional area ([Formula: see text]). High-quality CT images greatly reduce the time needed for geometric reconstruction. Significant advances in the accuracy of the reconstruction have resulted in more accurate CFD analysis, which can help to improve clinical diagnoses. The results of this study show that the CFD method can be a feasible tool for the clinic diagnosis of stenosis and for determining whether a patient requires percutaneous coronary intervention (PCI).

scholarly journals Angiographic evaluation of radial artery injury after transradial approach for percutaneous coronary intervention

2021 ◽  
Author(s):  
Takenori Kanazawa ◽  
Kiyotaka Shimamura ◽  
Kazuya Nagao ◽  
Hiroshi Yukawa ◽  
Kenji Aida ◽  
...  
Keyword(s):  
Percutaneous Coronary Intervention ◽  
Radial Artery ◽  
Odds Ratio ◽  
Coronary Intervention ◽  
Transradial Approach ◽  
Artery Injury ◽  
Percutaneous Coronary ◽  
History Of

AbstractThe transradial approach for percutaneous coronary intervention (TRA-PCI) has been increasingly gaining popularity in clinical practice. However, its association with risk for long-term radial artery injury has not been yet thoroughly defined. We retrospectively examined the patients undergoing radial artery angiography (RAG) after TRA-PCI to determine the incidence and risk factors of radial artery injury. The study included 558 patients undergoing follow-up radial artery angiography at 12 month after TRA-PCI. Radial artery injury occurred in 140 patients (25%) with 3 distinct morphological patterns: focal radial artery stenosis (RAS) P.7,7: in 7 patients (1%), diffuse radial artery stenosis (RAS) in 78 patients (14%), and radial artery occlusion (RAO) in 55 patients (10%). Patients with RAS/RAO were more likely to be female, had smaller height and body weight, smaller body mass index and smaller body surface area (BSA) as compared with those without RAS/RAO. Multivariable logistic regression analysis identified BSA (odds ratio, 1.34 per 0.1 m2 increase; 95% confidence interval, 1.07–1.71; p = 0.01) and a history of TRA-PCI (odds ratio, 2.35; 95% confidence interval, 1.16–5.08; p = 0.017) as independent predisposing factors of radial artery injury. In a sub-analysis of 323 patients undergoing both pre-PCI RAG and follow-up RAG, pre-PCI radial diameter as well as BSA and a history of TRA-PCI were independently associated with radial artery injury. Long-term injury after TRA-PCI is considerably common and care should be paid for RAS/RAO, especially for those patients with lower BSA, history of TRA-PCI and small radial artery diameter.

Kualitas Hidup Pasien Pascaintervensi Koroner Perkutan

1970 ◽  
Vol 2 (1) ◽  
Author(s):  
Remita Ully Hutagalung ◽  
F Sri Susilaningsih ◽  
Ai Mardiyah
Keyword(s):  
Quality Of Life ◽  
Percutaneous Coronary Intervention ◽  
Heart Disease ◽  
College Education ◽  
Coronary Intervention ◽  
Health Condition ◽  
Cross Sectional ◽  
Percutaneous Coronary ◽  
Environment Domain

Penyakit jantung koroner adalah penyakit yang dapat mengancam kehidupan seseorang. Pelaksanaan tindakan non bedah intervensi koroner perkutan pasien masih memiliki risiko terjadinya serangan berulang, stenosis dan ancaman kematian. Tujuan penelitian ini adalah mengidentifikasi kualitas hidup pasien pascatindakan intervensi koroner perkutan. Desain penelitian ini adalah potong lintang. Pengambilan sampel secara consecutive samplingdidapatkan 50 responden yaitu pasien yang sedang kontrol pascaintervensi coroner per kutan di Poliklinik Spesialis Jantung RSUP Dr. Hasan Sadikin Bandung, penelitian ini dilakukan pada 1-14 November 2013. Kualitas hidup diukur dengan instrumen WHOQOL-BREFdengan empat domain kualitas hidup yaitu domain fisik, psikologis, sosial, dan lingkungan. Analisis menggunakan statistik deskripsi. Hasil penelitian menunjukkan bahwa responden memiliki kualitas hidup baik sebesar 50%. Perawat memiliki peran dalam membantu pasien mencapai kualitas hidup yang optimal, diantaranya melalui peningkatan efikasi diri pasien melalui pendampingan dan pemberian informasi dalam usaha mencapai kualitas hidup.Kata kunci:Intervensi koroner perkutan, kualitas hidup, WHOQOL-BREF AbstractCoronary heart disease is a disease that can threaten person’s life, and can lead to the change of the quality of life. This coronary heart disease can be solved with non-surgical called percutaneous coronary intervention. This action will be normalized the quality of perfusion in the coronary arteries, which would certainly have an impact on the quality of life of patients. The research objective was to observe the patient of quality of life after treatment on intervention percutaneous coronary. The research design was cross sectional. There were 50 respondents taken by consecutive sampling. Data were collected in outpatient room in RSUP Dr. Hasan Sadikin Bandung, who have came with treatment routine schedule after percutaneous coronary intervention during November 1st–14th 2013. The questionnaire use WHOQOL-BREF format with 26 questions that consisting of 4 domains of quality of life: physical domain, psychological domain, social domain, and environment domain. Majority of patients were male (74 %), with the range of age mostly 56-66 years ( 34 % ), married ( 96 % ), college education was the highest ( 66 % ), the majority had not a primary job like as housewife , retired, student, etc. ( 26 % ). Data were collected using the questionnaire WHOQOL – BREF. The result have shown that rates of quality of life was good ( 50 % ) and health condition after percutaneous coronary intervention neither satisfied nor dissatisfied ( 44 % ). Nurses have a role in helping patients achieve optimal quality of life like giving information to patient correctlyKey words: Percutaneous coronary intervention, quality of life, WHOQOL – BREF

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