Keywords:
Recanalisation, Arterial access, Catheter arteriography, Vascular, Cardiac, Arteries / Aorta, Acute, Prospective, Case-control study, Performed at one institution
Authors:
K. Aleksandr, P. Podmetin, I. Kochanov, S. Seletskiy; Saint-Petersburg/RU
DOI:
10.26044/ecr2020/C-01441
Results
TENDERA RCT (n=240).
|
RA (norm) n=215
(93,7%)
|
RAO n=15
(6,3%)
|
Sex
|
M – 59%
|
F – 41%
|
M – 44%
|
F – 56%
|
Diameter RA (mm)
|
Δ2,6 ²
[2,3 – 2,9] ³
|
Δ 2,4 ²
[2,1 – 2,5] ³
|
5 Fr n=56 (24,4%) ⁴
6 Fr n=174 (75,6%) ⁴
|
5 Fr n=50 (89,3%)
6 Fr n=165 (94,8%)
|
5 Fr n=6 (10,7%)
6 Fr n=9 (5,2%)
|
Operation time (min)
|
Δ 25,2 ²
[6 – 38] ³
|
Δ 36,11 ²
[20 – 30] ³
|
High RA bifurcation n=15 (6,3%)
|
n=13 (86,7%)
|
n=2 (13,3%)
|
Spasm RA n=45 (18,8%)
|
n=38 (84,4%)
|
n=7 (15,6%)
|
Loop RA n=12 (5%)
|
n=11 (91,7%)
|
n=1 (8,3%)
|
Мediacalcinosis RA n=3 (1,3%)
|
n=3 (100%)
|
-
|
Injury RA n=13 (5,4%)
|
n=11 (84,6%)
|
n=2 (15,4%)
|
Heparin:
40-60 Ед/кг n=149 (62,1%)
90-110 Ед/кг n=91 (37,9%)
|
n=139 (93,3%)
n=86 (94,5%)
|
n=10 (6,7%)
n=5 (5,5%)
|
Note:1 Interim results of the TENDERA RCT.
2 Data presented by median.
3 Data presented by interquartile range.
4. The size of the introducer sheath.
The register of our clinic (n=2809).
|
RA (norm) n=2656
(94,5%)
|
RAO n=153
(5,4%)
|
Sex
|
M – 64%
|
F – 36%
|
M – 61%
|
F – 39%
|
Diameter RA (mm)
|
Δ 2,7²
[2,2 – 3,1] ³
|
Δ 2,3 ²
[2,1 – 2,5] ³
|
5 Fr n=7 (0,2%) ⁴
6 Fr n=2802 (99,8%)
|
5 Fr n=7 (100%)
6 Fr n=2649 (94,5%)
|
5 Fr ( - )
6 Fr n=153 (5,5%)
|
High RA bifurcation n=39 (1,4%)
|
n=31 (79,5%)
|
n=8 (21,5%)
|
Spasm RA n= 302(10,8%)
|
n=244 (80,8%)
|
n=58 (19,2%)
|
Loop RA n=109 (3,9%)
|
n=106 (97,2%)
|
n=3 (2,8%)
|
Мediacalcinosis RA n=18 (0,6%)
|
n=14 (77,8%)
|
n=4 (22,2%)
|
Injury RA n=305 (10,9%)
|
n=236 (77,4%)
|
n=69 (22,6%)
|
Heparin:
40-60 Ед/кг n=1397 (49,7%)
90-110 Ед/кг n=1412 (50,3%)
|
n=1313 (94%)
n=1343 (95,1%)
|
n=84 (6%)
n=69 (4,9%)
|
Note: 1.Own observations (data 2013- December 2019) Medical University. I.I. Mechnikov (patients with control of patency of the RA).
2 Data presented by median.
3 Data presented by interquartile range.
4. The size of the introducer sheath.
RAO with distal radial access (dRA) and proximal radial access (pRA)
trials
|
TENDERA
Interim results RCT
|
Own register
Own observations (data 2013 - December 2019
|
Rate access
|
dRA n=265
|
pRA n=240
|
dRA n=2255
|
pRA n=2809
|
RAO
|
n=8 (3%)
|
n=15 (6,3%)
|
n=32 (1,4%)
|
n=153(5,4%)
|
Recanalization RAO was performed in 104 patients. Total successful recanalization was performed in 85 (82%) patients. Success with retrograde approach noted in 99% of patients, with antegrade approach - in 83%. Reocclusion after the retrograde method was detected in 37% and only in 19% after the antegrade method.
Retrograde method. Operation time (min)-Δ 44,5, Fluoroscopy (min)-Δ 22, Kerma (mGy)-Δ 343. Antegrade method. Operation time (min)-Δ 35,2, Fluoroscopy (min)-Δ 21,1, Kerma (mGy)-Δ 281.
Dynamic strength analysis demonstrated that after the PCOFRA recanalization an insig nificantly increased number of the wrist exerciser grips was observedю Before recanalization-40,1. After recanalization-43,7. But patients did not feel these changes.