Document Detail


Analysis of peripheral arterial bends that interfere with coronary catheterization.
MedLine Citation:
PMID:  20440033     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
OBJECTIVES: The aim of this study was to analyze the characteristics of peripheral arterial bends that interfere with coronary catheterization. BACKGROUND: Complex aortic and peripheral arterial bends are important factors in unsuccessful coronary catheterization. Methods.We classified peripheral arterial bends based on the difficulty of coronary catheterization: no bend, type A: easy; type B1: difficult but possible; type B2: difficult but possible with assistance of a device such as a long sheath; type C: impossible. We analyzed 1,626 consecutive cardiac catheterizations. RESULTS: Reproducibility (+/- 1 grade) was 98.9% in 256 patients undergoing multiple procedures from the same approach site. Peripheral arterial bend class distribution was as follows: no bend: 76.4%, type A: 12.5%, type B1: 5.0%, type B2: 5.5%, and type C: 0.6%. Fluoroscopy time and contrast volume were significantly greater in type B2/C (9.6 +/- 6.26 min versus 13.8 +/- 8.9 min, p < 0.0001 and 142.0 +/- 38.8 ml versus 168.4 +/- 53.6 ml, p < 0.0001, respectively). There were no differences in the distribution of types B and C by approach site; femoral approach, 6.4%% right upper limb approach, 6.1%; and left upper limb approach, 5.0%. Furthermore, in the patients who underwent multiple catheterizations from different approach sites, the arterial bend classes were similar. Predictors of a type B2/C arterial bend were mainly atherosclerotic risk factors, suggesting that longitudinal arterial elongation is the major cause of arterial bends. CONCLUSIONS: Peripheral arterial bends are a feature of the individual patient, not of the approach site.
Authors:
Naoki Masuda; Takashi Matsukage; Nobuhiko Ogata; Yoshihiro Morino; Teruhisa Tanabe; Yuji Ikari
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Publication Detail:
Type:  Journal Article    
Journal Detail:
Title:  The Journal of invasive cardiology     Volume:  22     ISSN:  1557-2501     ISO Abbreviation:  J Invasive Cardiol     Publication Date:  2010 May 
Date Detail:
Created Date:  2010-05-04     Completed Date:  2010-08-20     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  8917477     Medline TA:  J Invasive Cardiol     Country:  United States    
Other Details:
Languages:  eng     Pagination:  197-203     Citation Subset:  IM    
Affiliation:
Department of Cardiology, Tokai University School of Medicine, Isehara, Kanagawa, Japan.
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MeSH Terms
Descriptor/Qualifier:
Aged
Angioplasty, Transluminal, Percutaneous Coronary / adverse effects,  methods*,  statistics & numerical data
Aorta / pathology
Brachial Artery
Coronary Angiography* / statistics & numerical data
Coronary Artery Disease / epidemiology,  radiography*,  therapy*
Coronary Vessels / pathology*
Female
Femoral Artery
Fluoroscopy / statistics & numerical data
Heart Catheterization / adverse effects,  methods*,  statistics & numerical data
Humans
Logistic Models
Male
Middle Aged
Predictive Value of Tests
Radial Artery
Risk Factors
Time Factors

From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine


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