Author + information
- Luis Berumen Dominguez Sr.,
- Andres Garcia-Rincon,
- Ricardo Kiamco,
- Jorge Carrillo-Guevara and
- German Bautista
Radial access is the access choice since many years in our hospital. For long time angioplasties were done by femoral access requiring more than 24 hrs of hospitalization. Nowadays radial access in the recent guidelines has an indication class IIa.
Show the great impact of a successful same day discharge radial angioplasty programa, his limitation and complications.
Materials and Method
It is an observational, longitudinal, prospective and descriptive study, which includes patients who were treated by radial coronary angioplasty in the hemodynamics service of la raza medical center. The procedures were done since November 2009 to January 2012. The inclusion criteria are: not complicates angioplasty, main left artery not affected, true bifurcation, good result without: 1. - Dissection, 2. - Hemodynamic instability, 3. Electrocardiographic changes, 4. - Angina, 5. - timi flow less than 3, 6.- thrombosis, 7.- more than 3 hours, 7.- more than 300 ml of contrast.
All patients received aspirin and clopidogrel and were checked for 6 hours in an observational area.
375 coronary angioplasties were done: 69% males, mean age 56 years, 60% diabetics, 50% with hypertension, 30% dyslipidemias and 60% smokers. The anterior descending coronary was the most affected vessel. We used in 72% patients drug eluting stents. Post procedure patients were checked at the first 48 hours, 1 month, and 6 months. 17% patients refer pain in the access site and were treated with analgesics. Only one patient present cellulitis in the forearm and was treated with antibiotics, 2 patients presented not complicated hematomas and one patient important edema in the forearm, because he didn′t take off the compressive apposite as indicated. There were no major cardiovascular complications.
The Same Day Discharge Radial Angioplasty is a safe procedure in appropriate selected patients, with no major complications and only 1.5% minor complications. It permits early stroll, with great comfort, easy and early discharge, reducing the hospitalization time by optimizing the human and material resources of de Institute with 100% of patients and family acceptation.
- 2013 American College of Cardiology Foundation