Radial Versus Femoral Access With or Without Vascular Closure Device in Patients With Acute Myocardial Infarction

Kim, Nam Kyeun; Lee, Jang Hoon; Jang, Se Yong; Bae, Myung Hwan; Yang, Dong Heon; Park, Hun Sik; Cho, Yongkeun; Yoon, Jae Yong; Cho, Jeong Gwan; Park, Jong Seon; Kim, Hyo Soo; Hur, Seung Ho; Seong, In Whan; Cho, Myeong Chan; Kim, Chong Jin; Chae, Shung Chull

doi:10.1016/j.amjcard.2018.11.040

Cited by 9 publications

(6 citation statements)

References 14 publications

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“…Similar findings were reported in a large observational registry available from the British Cardiovascular Intervention Society, United Kingdom 26 . A recent large observational study from Korea, comparing the outcome of major adverse cardiocerebrovascular events between TRA, TFA without VCD and TFA with VCD, found superiority of TRA over TFA without VCD (7.9% vs 11.3%, p < .001), but similar outcomes compared to TFA with VCDs (7.5% vs 8.1%, p = .43), albeit the events were numerically lower in the TRA group 27 . The benefits of radial access over femoral access have been well established in many randomized trials 3,25,28 but not all showing that TRA is safer 29 …”

Section: Discussionmentioning

confidence: 99%

“…26 A recent large observational study from Korea, comparing the outcome of major adverse cardiocerebrovascular events between TRA, TFA without VCD and TFA with VCD, found superiority of TRA over TFA without VCD (7.9% vs 11.3%, p < .001), but similar outcomes compared to TFA with VCDs (7.5% vs 8.1%, p = .43), albeit the events were numerically lower in the TRA group. 27 The benefits of radial access over femoral access have been well established in many randomized trials 3,25,28 but not all showing that TRA is safer. 29 Observational data has favored the use of closure devices, which have been associated with a lower incidence of vascular complications and need for blood transfusion 30 when compared with manual compression.…”

Section: Sub-group Analysismentioning

confidence: 99%

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Safety of transradial access compared to transfemoral access with hemostatic devices (vessel plugs and suture devices) after percutaneous coronary interventions: A systematic review and meta‐analysis

Chugh

Bavishi

Mojadidi

et al. 2020

Cathet Cardio Intervent

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Objectives: Comparing the safety of transradial access (TRA) and conventional hemostasis with transfemoral access (TFA) and vascular closure devices (vessel plugs and suture devices) in patients undergoing percutaneous coronary interventions. Background: TRA for PCIs is associated with fewer bleeding and vascular complications compared with TFA. Vascular closure devices (VCD) are often used post TFA to establish early hemostasis and mitigate bleeding risk. However, the comparative efficacy of TRA and TFA with VCDs remains controversial. Method: Electronic database were systematically searched for all pertinent studies from inception through January 2020. Randomized studies, registry data, and abstracts published in peer-reviewed indexed journals were included. The short-term outcomes: major bleeding, vascular complications, and closure device failure were evaluated. Random-effects model was used to pool individual study results. Results: Twelve studies (8 observational, 4 randomized) including 7,961 patients (TRA: 3,121 patients, TFA and vessel plugs: 3,157 patients, TFA & suture devices: 1,683 patients) were included in the analysis. Major bleeding was significantly lower with TRA compared with TFA and vessel plugs (odds ratio [OR] 0.22, 95%CI 0.11-0.44, p < .00001) and TFA & suture devices (OR 0.12, 95%CI 0.05-0.28, p < .00001). Vascular complications were significantly lower with TRA compared to TFA and vessel plugs (OR 0.25, 95%CI 0.13-0.49, p < .0001) and TFA & suture devices (OR 0.13, 95%CI 0.04-0.41, p = 0.0005). Rates of closure device failure were lower for TRA compared to TFA & suture devices (OR 0.13, 95%CI 0.04-0.41, p = .0005), but similar to TFA & vessel plugs (OR 0.23, 95%CI 0.01-4.28, p = .33), although confidence intervals were wide. All analysis revealed a low to moderate level of heterogeneity.

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Section: Discussionmentioning

confidence: 99%

Section: Sub-group Analysismentioning

confidence: 99%

Safety of transradial access compared to transfemoral access with hemostatic devices (vessel plugs and suture devices) after percutaneous coronary interventions: A systematic review and meta‐analysis

Chugh

Bavishi

Mojadidi

et al. 2020

Cathet Cardio Intervent

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“…First, our technique was shown to be safe and easy to perform using standard laboratory catheterization equipment. Although simultaneous femoral artery access was required, the utilization of vascular closure devices (VCD) could effectively reduce access-site complications and bleeding for patients with acute myocardial infarction undergoing a transfemoral approach [ 26 , 27 ]. VCD was utilized in 26 patients in our study, none of whom encountered vascular complications.…”

Section: Discussionmentioning

confidence: 99%

A Novel Reperfusion Strategy for Primary Percutaneous Coronary Intervention in Patients with Acute ST-Segment Elevation Myocardial Infarction: A Prospective Case Series

Yang

et al. 2023

JCM

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Background: Ischemia reperfusion injury (IRI) remains a major problem in patients with acute ST-segment elevation myocardial infarction (STEMI) undergoing primary percutaneous coronary intervention (PCI). We have developed a novel reperfusion strategy for PCI and named it “volume-controlled reperfusion (VCR)”. The aim of the current study was to assess the safety and feasibility of VCR in patients with STEMI. Methods: Consecutive patients admitted to Beijing Chaoyang Hospital with STEMI were prospectively enrolled. The feasibility endpoint was procedural success. The safety endpoints included death from all causes, major vascular complications, and major adverse cardiac event (MACE), i.e., a composite of cardiac death, myocardial reinfarction, target vessel revascularization (TVR), and heart failure. Results: A total of 30 patients were finally included. Procedural success was achieved in 28 (93.3%) patients. No patients died during the study and no major vascular complications or MACE occurred during hospitalization. With the exception of one patient (3.3%) who underwent TVR three months after discharge, no patient encountered death (0.0%), major vascular complications (0.0%), or and other MACEs (0.0%) during the median follow-up of 16 months. Conclusion: The findings of the pilot study suggest that VCR has favorable feasibility and safety in patients with STEMI. Further larger randomized trials are required to evaluate the effectiveness of VCR in STEMI patients.

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“…Европейские руководства от 2017 года указывают, что для первичного ЧКВ установление стента должно быть в пораженной артерии и стент с лекарственным покрытием (элюированием) предпочтительнее, чем стент голого металла. Кроме того, радиальный доступ может быть предпочтительным по сравнению с бедренным доступом, когда он выполняется опытным оператором [21,26].…”

Section: Selection Of a Modern Strategy For The Treatment Of Acute Co...unclassified

“…Для принятия решения о том, следует ли использовать фибринолиз, предпочтительно должен осуществится в течение первых 30 минут после первого медицинского контакта. Эта стратегия может быть достигнута либо в виде догоспитального фибринолиза (неотложной медицинской помощи), либо в течение 30 минут после прибытия в учреждение, где нет условий для проведения ЧКВ (время от двери до иглы) [26]. У постели больного оперативно рассматриваются противопоказания к фибринолизу.…”

Section: Selection Of a Modern Strategy For The Treatment Of Acute Co...unclassified

Selection of a modern strategy for the treatment of acute coronary syndrome with elevated ST segment

Шукурова¹,

Kabirzoda²,

Radzhabova³

et al. 2022

jour

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The review is based on the analysis of current literature data on acute coronary syndrome (ACS): definition, epidemiology, classification, and methods of modern therapy methods. The article presents in detail the premedication and reperfusion strategies of introduction with an emphasis on a differential approach in the choice of therapy depending on the state of the ST-segment elevation. According to the literature the choice of treatment differs in patients with ACS with ST. The results of multicenter studies on the use of anticoagulant therapy in ACS and the need for double anticoagulant therapy against the background of the use of statins, ACE inhibitors, and beta blockers are presented.

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Radial Versus Femoral Access With or Without Vascular Closure Device in Patients With Acute Myocardial Infarction

Cited by 9 publications

References 14 publications

Safety of transradial access compared to transfemoral access with hemostatic devices (vessel plugs and suture devices) after percutaneous coronary interventions: A systematic review and meta‐analysis

Safety of transradial access compared to transfemoral access with hemostatic devices (vessel plugs and suture devices) after percutaneous coronary interventions: A systematic review and meta‐analysis

A Novel Reperfusion Strategy for Primary Percutaneous Coronary Intervention in Patients with Acute ST-Segment Elevation Myocardial Infarction: A Prospective Case Series

Selection of a modern strategy for the treatment of acute coronary syndrome with elevated ST segment

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