J Transcat Intervent.2018;26:eA0008.
Percutaneous coronary intervention for unprotected left main coronary artery: radial vs. femoral access
DOI: 10.31160/JOTCI2018;26(1)A0008
ABSTRACT
Background
Percutaneous intervention for obstructive lesions of the unprotected left main coronary artery is complex. Choosing the vascular access can be decisive to a successful procedure. The objective of the present study was to describe the characteristics and hospital outcomes of patients with unprotected left main coronary artery disease and compare the radial and femoral access approaches.
Methods
Clinical and angiographic data, access routes and hospital outcomes of patients that have undergone percutaneous coronary intervention of the unprotected left main coronary artery were collected from the Central Nacional de Intervenções Cardiovasculares (CENIC) between June 2006 and March 2016.
Results
A total of 734 patients were included. Mean age was 66±12 years, 62% were male and 22% were diabetic. Acute coronary syndrome occurred in 47%. Cardiogenic shock was observed in 44% of patients with acute myocardial infarction. The procedure success rate was 90% and the hospital mortality rate was 8.5%. Femoral access was the most frequent approach. Regardless of the vascular approach used, there was no difference in the rate of major adverse cardiovascular events during hospital stay.
Conclusions
High clinical complexity was observed in CENIC patients presenting with unprotected left main coronary artery lesions treated by percutaneous coronary intervention. Femoral access was the most frequent, especially for more complex cases. There was no difference between the procedure success rate and adverse event rate when comparing both vascular approaches.
Keywords: Angioplasty; Coronary artery disease; Femoral artery; Radial artery
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