Assuntos
Doença da Artéria Coronariana/tratamento farmacológico , Fibrinolíticos/uso terapêutico , Infarto do Miocárdio/tratamento farmacológico , Reperfusão Miocárdica/métodos , Terapia Trombolítica/métodos , Terapia Combinada , Doença da Artéria Coronariana/diagnóstico por imagem , Doença da Artéria Coronariana/mortalidade , Medicina Baseada em Evidências , Feminino , Fibrinolíticos/efeitos adversos , Hemorragia/induzido quimicamente , Hemorragia/epidemiologia , Humanos , Índia , Masculino , Infarto do Miocárdio/diagnóstico , Infarto do Miocárdio/mortalidade , Infarto do Miocárdio/terapia , Prognóstico , Radiografia , Ensaios Clínicos Controlados Aleatórios como Assunto , Medição de Risco , Papel (figurativo) , Análise de Sobrevida , Terapia Trombolítica/efeitos adversos , Resultado do TratamentoRESUMO
OBJECTIVE: To study the suitability of the aberrant radial artery (ARA) as an access site for coronary angiography and angioplasty. BACKGROUND: In certain situations, the radial artery operator finds that the right radial artery in its usual location is unsuitable for a transradial procedure (TRP). In such cases, the ARA should be considered as an alternate access site. METHODS: Between January 2002 and December 2004, all patients considered suitable for a TRP with a clinically absent radial artery, or a small radial artery and a palpable ARA, underwent a TRP using this vessel as an access site. We describe the technical aspects and the differences that this approach entails, in comparison to the standard radial artery approach to TRPs. RESULTS: Of the 3,610 patients considered suitable for a TRP, 22 patients underwent 29 procedures using the ARA as an access site [22 angiograms and 7 percutaneous transluminal coronary angioplasty procedures (PTCAs)]. The median age of the patients was 55 years, with 19 males and 3 females. All procedures using the aberrant radial artery were successful. None of the patients developed spasm or an access site complication. The mean fluoroscopy time for angiography in the right radial artery group was 4.6 minutes, and 4.8 minutes for the ARA group. The procedure timed were 24 minutes and 32 minutes, respectively. CONCLUSION: The aberrant radial artery can be used as a safe alternate access site for coronary angiography and angioplasty when the right radial artery at the usual site is not suitable.
Assuntos
Angioplastia com Balão/métodos , Angiografia Coronária/métodos , Artéria Radial/anormalidades , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Punções/métodos , Fatores de TempoAssuntos
Aorta Torácica/diagnóstico por imagem , Arteriopatias Oclusivas/diagnóstico por imagem , Complicações Cardiovasculares na Gravidez/diagnóstico por imagem , Arterite de Takayasu/diagnóstico por imagem , Ultrassonografia Pré-Natal , Adulto , Arteriopatias Oclusivas/complicações , Cesárea , Feminino , Humanos , Gravidez , Resultado da Gravidez , Arterite de Takayasu/complicaçõesRESUMO
This study was done to find out whether successful balloon mitral valvotomy (BMV) reduces the severity of associated functional tricuspid regurgitation (TR), and if so, which variables predict this reduction. Of the 177 consecutive patients who underwent BMV, 53 were found to have functional TR. 2D echocardiography (Echo) with color Doppler was done before and 24-48 hours after BMV. Using the apical four-chamber view, the severity of TR was assessed by comparing the ratio of maximal tricuspid regurgitant jet area (TRA) to right atrial area (RAA). There was a significant reduction in TRA:RAA, after BMV (0.26 to 0.12; p < 0.05). Stepwise multiple regression analysis showed that the predictors of TR reduction were: age less than 24 years (r = 0.56, p < 0.004), cardiothoracic ratio measured on chest X-ray > 60% (r = 0.43, p < 0.002) and pre-BMV pulmonary artery systolic pressure (PASP) > 50 mm Hg (r = 0.51, p < 0.001).
