Current State of Radial Artery Catheterization in ST-Elevation Myocardial Infarction

Hinohara, Tomoya; Rao, Sunil V.

doi:10.1016/j.pcad.2015.07.007

Cited by 11 publications

(6 citation statements)

References 31 publications

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“…31 Currently, the routine use of thrombus aspiration during PCI is not indicated, and selective use is viewed as poorly founded (ACC-AHA class IIb recommendation, evidence level C). 23 In response to adverse outcomes associated with bleeding complications of PCI, radial-artery access has been advocated for coronary angiography and PCI, 32 particularly for patients with STEMI, in whom bleeding at the access site is most common. A meta-analysis of 12 randomized trials comparing transradial with transfemoral PCI for the treatment of STEMI showed that radial access was associated with lower rates of accesssite bleeding (2.1% vs. 5.6%), major bleeding (1.4% vs. 2.9%), and death (2.7% vs. 4.7%), despite a procedure time that was 2 minutes longer.…”

Section: Therapeutic Target Interventionmentioning

confidence: 99%

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Acute Myocardial Infarction

2017

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Section: Therapeutic Target Interventionmentioning

confidence: 99%

“…34 One challenge to rapid adoption of the radial approach in general practice is overcoming the learning curve for achieving the outcomes observed in clinical trials. 32…”

Section: Therapeutic Target Interventionmentioning

confidence: 99%

Acute Myocardial Infarction

2017

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“…7 Although the superiority of transradial access over the femoral access is proven, in addition to the undeniable benefits to patients, the femoral route is a priority among more experienced operators. 18,19 In Angola, in recent years, the trend has been the use of transradial access for PCI, which is associated with lower rates of complications, mortality and shorter hospital stay, especially in patients with acute MI. 20 Reducing the delay in the first medical contact remains one of the great challenges in Angola; however there is a need to address some aspects that decisively influence the context of delay for patients in the country, making this an "Achilles heel" in our daily practice, a fact that was reflected in this investigation, with inadmissible delays for patients.…”

Section: Discussionmentioning

confidence: 99%

Primary angioplasty in acute myocardial infarction: initial experience in a developing country

Vicente¹,

Dopico²,

Domingos³

et al. 2021

J Transcat Intervent

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Background: Coronary artery disease is a major public health concern worldwide. In Africa, varying rates of progression increased in different countries. In Angola, although the epidemiological scenario is dominated by infectious diseases, the prevalence of coronary artery disease is increasing with notable impacts, requiring the creation of mechanisms to face this reality in a country where lack of specific infrastructure is still a challenge. The objective of this study was to describe the experience of primary angioplasty in patients with acute myocardial infarction in an Angolan tertiary care center. Methods: This was a descriptive, longitudinal, retrospective study, involving 165 patients diagnosed with acute myocardial infarction between 2012 and 2019. Variables were age, sex, risk factors, angiographic and procedure-related characteristics, and main complications. Results: The mean age was 58.3±6.8 years, and males predominated (75.8%). Hypertension (69.7%), dyslipidemia (35.2%), smoking (32.7%) and diabetes (29.7%) were more prevalent. The anterior location was the predominant topography of infarction (49.7%). Single vessel disease was the most common pattern (50.9 %). The left anterior descending artery was the most often involved vessel (49.7%). The door-to-balloon time was 46.6±32.4 minutes. In the multivariate analysis, anterior myocardial infarction (p=0.033), diabetes (p=0.004), age ≥60 years (p≤0.001) and post-coronary intervention final TIMI flow Conclusion: Percutaneous coronary intervention in the context of acute myocardial infarction in Angola is a reality, but the number of procedures performed is not enough given the current great demand.

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“…In addition, the radial access is a class 1 recommendation according to European Society of Cardiology guidelines, whereas the AHA/ACC guidelines do not give an explicit recommendation. 59 Radial access will continue to surpass femoral access, and its mortality benefit has been repeatedly shown. In the setting of unstable STEMI/ACS necessitating temporary pacing and/or large-bore access for hemodynamic support, it is unclear whether there is still superiority with radial access.…”

Section: Future Directions and Controversiesmentioning

confidence: 99%

The Evolving Face of Myocardial Reperfusion in Acute Coronary Syndromes: A Primer for the Internist

Widmer

Pollak

Bell

et al. 2018

Mayo Clinic Proceedings

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Acute coronary syndromes (ACSs) account for a large proportion of disease burden in the United States and worldwide, and our understanding of ACS management continues to evolve. In this review we take a practical approach to evaluating and treating a patient with ACS, focusing on the optimal timing and methods of coronary reperfusion. Beginning with initial assessment and risk stratification, a provider managing the patient with ACS must be able to expeditiously decide on and implement the correct guideline-directed pathway to optimize outcomes. With an ever-growing body and weight of knowledge in this field, the clinician is tasked with several challenges. First, there are a variety of pathways of care to be considered; second, adjunctive medical therapies are expanding; and third, when coupled with the multiple combinations of adjunctive supportive therapies for revascularization, the variety of potential therapeutic options can be overwhelming and confusing. Herein, we carefully review all the relevant guidelines and the contributing literature, taking a 4-step approach: (1) review the importance of risk stratification before engaging in a particular strategy of care, (2) define the reperfusion strategies available, (3) review the specific agents (antiplatelet and anticoagulant) that support reperfusion strategies, and (4) apply the strategies of care in the context of the clinical presentation.

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Current State of Radial Artery Catheterization in ST-Elevation Myocardial Infarction

Cited by 11 publications

References 31 publications

Acute Myocardial Infarction

Acute Myocardial Infarction

Primary angioplasty in acute myocardial infarction: initial experience in a developing country

The Evolving Face of Myocardial Reperfusion in Acute Coronary Syndromes: A Primer for the Internist

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