دورية أكاديمية
Ultrasound- Versus Fluoroscopy-Guided Femoral Access for Percutaneous Coronary Intervention of Chronic Total Occlusions: Insights From FOUND BLOOD CTO Registry.
| العنوان: | Ultrasound- Versus Fluoroscopy-Guided Femoral Access for Percutaneous Coronary Intervention of Chronic Total Occlusions: Insights From FOUND BLOOD CTO Registry. |
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| المؤلفون: | Piedimonte G; Division of Cardiology, C.A.S.T., Azienda Ospedaliero-Universitaria 'Policlinico G.Rodolico - San Marco', University of Catania, Catania, Italy., Bertagnin E; Division of Cardiology, C.A.S.T., Azienda Ospedaliero-Universitaria 'Policlinico G.Rodolico - San Marco', University of Catania, Catania, Italy., Castellana C; Division of Cardiology, C.A.S.T., Azienda Ospedaliero-Universitaria 'Policlinico G.Rodolico - San Marco', University of Catania, Catania, Italy., Ferrarotto L; Division of Cardiology, C.A.S.T., Azienda Ospedaliero-Universitaria 'Policlinico G.Rodolico - San Marco', University of Catania, Catania, Italy., Mangione R; Division of Cardiology, C.A.S.T., Azienda Ospedaliero-Universitaria 'Policlinico G.Rodolico - San Marco', University of Catania, Catania, Italy., Venuti G; Division of Cardiology, C.A.S.T., Azienda Ospedaliero-Universitaria 'Policlinico G.Rodolico - San Marco', University of Catania, Catania, Italy., Valvo R; Division of Cardiology, C.A.S.T., Azienda Ospedaliero-Universitaria 'Policlinico G.Rodolico - San Marco', University of Catania, Catania, Italy., Scalia M; Division of Cardiology, C.A.S.T., Azienda Ospedaliero-Universitaria 'Policlinico G.Rodolico - San Marco', University of Catania, Catania, Italy., Capodanno D; Division of Cardiology, C.A.S.T., Azienda Ospedaliero-Universitaria 'Policlinico G.Rodolico - San Marco', University of Catania, Catania, Italy., Tamburino C; Division of Cardiology, C.A.S.T., Azienda Ospedaliero-Universitaria 'Policlinico G.Rodolico - San Marco', University of Catania, Catania, Italy., La Manna A; Division of Cardiology, C.A.S.T., Azienda Ospedaliero-Universitaria 'Policlinico G.Rodolico - San Marco', University of Catania, Catania, Italy. Electronic address: lamanna.cardio@gmail.com. |
| المصدر: | Cardiovascular revascularization medicine : including molecular interventions [Cardiovasc Revasc Med] 2022 May; Vol. 38, pp. 61-67. Date of Electronic Publication: 2021 Aug 28. |
| نوع المنشور: | Journal Article |
| اللغة: | English |
| بيانات الدورية: | Publisher: Elsevier Country of Publication: United States NLM ID: 101238551 Publication Model: Print-Electronic Cited Medium: Internet ISSN: 1878-0938 (Electronic) Linking ISSN: 18780938 NLM ISO Abbreviation: Cardiovasc Revasc Med Subsets: MEDLINE |
| أسماء مطبوعة: | Original Publication: New York, NY : Elsevier, c2005- |
| مواضيع طبية MeSH: | Coronary Occlusion*/diagnostic imaging , Coronary Occlusion*/etiology , Coronary Occlusion*/therapy , Percutaneous Coronary Intervention*/adverse effects, Chronic Disease ; Coronary Angiography/adverse effects ; Fluoroscopy ; Hematoma/etiology ; Heparin ; Humans ; Registries ; Risk Factors ; Treatment Outcome |
| مستخلص: | Objective: To compare vascular complications in patients undergoing percutaneous coronary intervention (PCI) of chronic total occlusions (CTO) using ultrasound guidance (USG) versus fluoroscopy guidance (FSG) for femoral access. Background: In patients undergoing PCI, using the arterial femoral access increases the risk of vascular complications compared using the radial access. USG reduces time to access, number of attempts, and vascular complications compared with FSG, but the efficacy of USG has never been tested in the setting of CTO-PCI. Methods: A total of 197 patients undergoing CTO-PCI using at least a femoral vascular access from November 2015 to September 2020 were screened. The primary outcome was a composite of local hematoma, pseudoaneurysm, retroperitoneal hemorrhage, arteriovenous fistula or hemoglobin drop ≥3 g/dL during hospitalization. The independent association between USG and the primary outcome of interest was explored. Results: The primary outcome occurred in 17.3% of patients. Patients in the USG group had a significantly lower incidence of vascular complications compared with patients in the FSG group (8.5% vs. 21.0%, p = 0.039), driven by a reduction of localized hematomas (3.4% vs 13.0%, p = 0.042). After adjustment for type of CTO approach and heparin dose, USG was significantly associated with a reduced relative risk of the composite primary outcome (adjusted odds ratio 0.16, 95% confidence interval 0.05 to 0.51; p = 0.002). Conclusion: USG in CTO-PCI is associated with a decreased risk of vascular complications, primarily driven by a reduction in local hematomas, especially in complex CTO-PCI where the larger use of heparin increases the risk of vascular complications. Competing Interests: Declaration of competing interest Corrado Tamburino is consultant for Medtronic and received speaker honoraria from Meril. Davide Capodanno declares consulting fees from Bayer, Daiichi Sankyo, and lecture fees from AstraZeneca, Biotronik, Daiichi Sankyo, Medtronic, Menarini. Alessio La Manna is proctor for Kardia srl, Terumo Italia and GADA spa. The other coauthors do not have any conflict of interest related to this study. (Copyright © 2021 Elsevier Inc. All rights reserved.) |
| التعليقات: | Comment in: Cardiovasc Revasc Med. 2022 May;38:68-69. (PMID: 35165048) |
| فهرسة مساهمة: | Keywords: Chronic total occlusion (CTO); Complex percutaneous coronary intervention (PCI); Fluoroscopy guidance (FSG); Ultrasound guidance (USG) |
| المشرفين على المادة: | 9005-49-6 (Heparin) |
| تواريخ الأحداث: | Date Created: 20210924 Date Completed: 20220511 Latest Revision: 20220514 |
| رمز التحديث: | 20240829 |
| DOI: | 10.1016/j.carrev.2021.08.024 |
| PMID: | 34556431 |
| قاعدة البيانات: | MEDLINE |
Full Text via ClinicalKey 
Full Text Finder | تدمد: | 1878-0938 |
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| DOI: | 10.1016/j.carrev.2021.08.024 |