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Incidencia, impacto funcional y factores predictores para la presentación de complicaciones asociadas al acceso radial para coronariografía evaluadas por medio de ultrasonografía, cohorte hospitalaria

INTRODUCTION: Radial arterial access is one of the main ways to perform left heart catheterization and coronary angiography in different clinical settings, due to its lower rate of local complications and similar clinical results to when using the femoral access. OBJECTIVE: To determine the incidenc...

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Detalles Bibliográficos
Autores principales: García-Rueda, Karen A., Cediel-Barrera, César H., Plaza-Tenorio, Maribel, Cataño-Bedoya, John U., Ortiz-Uribe, Juan C., Toro-Osorio, Keyner, Peña-Pineda, Mailyn, Senior-Sánchez, Juan M.
Formato: Online Artículo Texto
Lenguaje:English
Publicado: Permanyer Publications 2022
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9005181/
https://www.ncbi.nlm.nih.gov/pubmed/34544116
http://dx.doi.org/10.24875/ACM.21000211
Descripción
Sumario:INTRODUCTION: Radial arterial access is one of the main ways to perform left heart catheterization and coronary angiography in different clinical settings, due to its lower rate of local complications and similar clinical results to when using the femoral access. OBJECTIVE: To determine the incidence of complications of radial access in interventional cardiology procedures of a hemodynamic service, as well as the impact on functionality and predictive factors for presentation. METHODOLOGY: Prospective observational cohort-type study in patients undergoing radial access coronary angiography in a university hospital with collection of demographic, clinical and ultrasound data prior to the procedure and 24 hours after it; The statistical model of logistic regression was applied to evaluate the association between the variables and the complications. RESULTS: 100 patients were obtained, 62% men, with a mean age of 64 years, 69% had arterial hypertension, 38% diabetes mellitus, 35% dyslipidemia, 2% peripheral arterial disease, and 10% chronic kidney disease. The reason for coronary angiography was non-ST-segment elevation acute coronary syndrome (NSTE-ACS) 65%, ST-segment elevation myocardial infarction (STEMI) 28%, pre-surgical 6%, and chronic coronary syndrome 1%. A 6 Fr introducer was used in all of them. 13% complications were documented, the most common being arterial occlusion and hematoma. Only one had implications for the functionality of the hand after a complication. After multivariate regression, height (<1.65 m) and dynamometry (<25 pounds) were found as predictive factors by area under the curve analysis using the Youden index. CONCLUSION: The present cohort had an incidence of complications detected by ultrasound of 13%, although none of these had direct clinical implications and only one reported alteration in functionality. Height less than 1.65 m and dynamometry less than 25 pounds were found as predictive factors.