Vacular Complication Comparison between Radial versus Femoral Approach of Primary Percutaneous Coronary Intervention using Eptifibatide
Abstract
Background.The transfemoral approach for percutaneous coronary intervention (PCI) has the complications in vascular access site more than transradial approach. Risk of vascular complications will increase in using eptifibatide.Methods.. This is a prospective cross sectional study involving 52 STEMI patients qualified to primary PCI. 26 patients in transfemoral approaches and 26 patients in transradial approaches. In these two groups, we compare the incidence of vascular complications such as bleeding, arteriovenous fistula, pseudoaneurysm and artery occlusion.
Results. From the 52 subjects of this study, found 94.2% men and 5.8% women, mean age 54.3 ± 9.9 years with the highest risk factors were smoking (67.3%), hypertension (51.9%), dyslipidemia (34.6%), diabetes (30.8%) and family history (11.5%). There were no significantly statistic relationship between duration of puncture and PCI procedures between the two groups. Incidence of vascular complications occurred in the femoral group (19.1% vs. 0), consist of arteriovenous fistula (11,5%), pseudoan-eurysm (3,8%), and minor bleeding (3,8%). Minor bleeding occurred in female subject with age 77 years.
Conclusion. There was no significant difference in vascular complications between transfemoral approaches with transradial approaches on the Primary PCI
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References
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Widimský P, Budešínský T, Vorác D, Groch L, Želízko M, Aschermann M, et al. Long Distance Transport for Primary Angioplasty vs Immediate Thrombolysis in Acute Myocardial Infarction: Final Results of the Randomized National Multi-centre Trial—PRAGUE-2. Eur Heart J. 2003; 24: 94-104.
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Ziakas A, Gomma A, McDonald J, Klinke P, Hilton D, A com-parison of the radial and the femoral approaches in primary or rescue percutaneous coronary intervetion for acute myocardial infarction in the elderly. Acute Cardiac Care. 2007; 9: 93–6.
Choussat R, Black A, Bossi I, et al. Vascular complications and clinical outcome after coronary angioplasty with platelet IIB/IIIA receptor blockade. Eur Heart J. 2000; 21: 662-7
Srinivas VS, Skeif B, Negassa A, Bang JY, Shaqra H, Monrad ES. Effectiveness of GPIIb/IIIa inhibitor use during primary coronary angioplasty: result of propensity analysis using the New York state percutaneous coronart intervention reporting system. Am J Cardiol. 2007; 99: 482-5.
Yan ZX, Zhou YJ, Liu YY, et al. Safety and feasibility of trans-radial approach for primary percutaneous coronary intervention in elderly patients with acute myocardial infarction. Chin Med J. 2008; 121: 782-6
Le May MR, Wells GA, Glover CA, et al : Primary percuta-neous coronary angioplasty with and without eptifibatide in ST-Segment elevation myocardial infarction. Circ Cardiovasc Intervent. 2009; 2: 330-338
Chodor P, Krupa H, Kurek T, et al. Radial versus femoral approach for percutaneous coronary interventions in patients with Acute Myocardial Infarction (RADIAMI): A prospecctive, randomized, single-center clinical trial. Eur Heart J. 2007; 28: 663.
Grier D, Hartnell G. Percutaneous femoral artery puncture: practice and anatomy. The British J Radiol. 1990; 63: 602-4.
Netter FH. Atlas of Human Anatomy, 2nd ed, New Jersey: ICON Learning System. 1997: 442-9.
Rigattieri S, Tian J. Radial versus femoral approach for coronary interventions. In: Hamon M, Mc Fadden E, editors. Trans radial approach for cardiovascular interventions. Carpiquet: ESM Editions. 2003: 79-90.
Van de Werf F, Bax , Betriu A,et al. Management of acute myocardial infarction in patients presenting with persistent ST-segment elevation:The Task Force on the management of ST-segment elevation acute myocardial infarction of the European Society of Cardiology. Eur Heart J.2008; 29: 2909–45.
Stone GW. Analysis of the Relative Costs and Effectiveness of Primary Angioplasty Versus Tissue-Type Plasminogen Activator: The PrimaryAngioplasty in Myocardial Infarction (PAMI) Trial. J Am Coll Cardiol. 1997; 29: 901–7.
Aversano T. The Atlantic C-PORT Trial: A Community-Hospital–Based, Prospective Randomized Trial Comparing Thrombolytic Therapy With Primary Percutaneous Coronary Intervention. Circulation. 2000; 102: 2794.
Armstrong PW, Fu Y, Chang WC, Topol EJ, Granger CB, Betriu A, et al. Acute Coronary Syndromes in the GUSTO-IIb Trial : Prognostic Insights and Impact of Recurrent Ischemia. Circulation. 1998; 98: 1860-8.
Bednar F, Widimsky P, Krupicka J et al. On behalf of the PRAGU Investigators. Interhospital transport for primary an-gioplasty improves the long-term outcome of acute myocardial infarction compared with immediate thrombolysis in the nearest hospital (one-year follow-up of the PRAGUE-1 study). Can J Cardiol. 2003; 19: 1133–7.
Widimský P, Budešínský T, Vorác D, Groch L, Želízko M, Aschermann M, et al. Long Distance Transport for Primary Angioplasty vs Immediate Thrombolysis in Acute Myocardial Infarction: Final Results of the Randomized National Multi-centre Trial—PRAGUE-2. Eur Heart J. 2003; 24: 94-104.
Mann T, Cubeddu G, Bowen J, et al. Stenting in acute coronary syndromes: a comparison of radial versus femoral access sites. J Am Coll Cardiol. 1998;32:572–6.
Moo HK, Kwang SC, Hye JK, et al. Primary Stenting for Acute Myocardial Infarction via the Transradial Approach: A Safe and Useful Alternative to the Transfemoral Approach. J Invasive Cardiol. 2000; 12: 724-8.
Franchi E, Marino P, Biondi-Zoccai GG, et al. Transradial versus transfemoral approach for percutaneous coronary procedures. Curr Cardiol Rep. 2009;11: 391-7.
Valsecchi O, Musumeci G, Vassileva A, et al. Safety, feasibility and efficacy of transradial primary angioplasty in patients with acute myocardial infarction. Ital Heart J. 2003;4:329–34.
Ziakas A, Gomma A, McDonald J, Klinke P, Hilton D, A com-parison of the radial and the femoral approaches in primary or rescue percutaneous coronary intervetion for acute myocardial infarction in the elderly. Acute Cardiac Care. 2007; 9: 93–6.
Choussat R, Black A, Bossi I, et al. Vascular complications and clinical outcome after coronary angioplasty with platelet IIB/IIIA receptor blockade. Eur Heart J. 2000; 21: 662-7
Srinivas VS, Skeif B, Negassa A, Bang JY, Shaqra H, Monrad ES. Effectiveness of GPIIb/IIIa inhibitor use during primary coronary angioplasty: result of propensity analysis using the New York state percutaneous coronart intervention reporting system. Am J Cardiol. 2007; 99: 482-5.
Yan ZX, Zhou YJ, Liu YY, et al. Safety and feasibility of trans-radial approach for primary percutaneous coronary intervention in elderly patients with acute myocardial infarction. Chin Med J. 2008; 121: 782-6
Le May MR, Wells GA, Glover CA, et al : Primary percuta-neous coronary angioplasty with and without eptifibatide in ST-Segment elevation myocardial infarction. Circ Cardiovasc Intervent. 2009; 2: 330-338
Chodor P, Krupa H, Kurek T, et al. Radial versus femoral approach for percutaneous coronary interventions in patients with Acute Myocardial Infarction (RADIAMI): A prospecctive, randomized, single-center clinical trial. Eur Heart J. 2007; 28: 663.
Grier D, Hartnell G. Percutaneous femoral artery puncture: practice and anatomy. The British J Radiol. 1990; 63: 602-4.
Netter FH. Atlas of Human Anatomy, 2nd ed, New Jersey: ICON Learning System. 1997: 442-9.
Rigattieri S, Tian J. Radial versus femoral approach for coronary interventions. In: Hamon M, Mc Fadden E, editors. Trans radial approach for cardiovascular interventions. Carpiquet: ESM Editions. 2003: 79-90.
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How to Cite
Hafidiansyah, S., Yuniadi, Y., & Soerianata, S. (1). Vacular Complication Comparison between Radial versus Femoral Approach of Primary Percutaneous Coronary Intervention using Eptifibatide. Indonesian Journal of Cardiology, 32(2), 79-85. https://doi.org/10.30701/ijc.v32i2.104
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Clinical Research
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