Document Detail


Intracoronary stent implantation via the brachial approach: a technique to reduce vascular bleeding complications.
MedLine Citation:
PMID:  1571993     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
To reduce the incidence of vascular complications of intracoronary stent implantation, we used the brachial approach. We attempted implantation of the Palmaz-Schatz stent via the brachial artery approach at 10 lesions in 9 patients. Stent delivery was successful at 8 lesions. Balloon angioplasty was successfully performed in the 2 failed cases, 1 of whom required surgical repair of the brachial artery. Intravenous anticoagulation was uninterrupted from the time of stent placement until therapeutic prothrombin times from oral warfarin therapy were obtained. Neither acute nor long-term major bleeding occurred in the 9 patients. There were no embolic events, myocardial infarctions, or deaths. One subacute thrombosis occurred, and the patient underwent bypass surgery. To evaluate the risks and benefits of the brachial approach, we compared these 9 patients with 41 who had stent placement by the femoral approach during the same period. Lesion characteristics were similar in these 2 groups. There were no significant differences in the success rate or angiographic outcome between the 2 groups. Seven (17%) patients in the femoral group had vascular access complications requiring surgery, compared with 1 (11%) in the brachial group. No patient in the brachial group required transfusion, compared with all 7 of the patients who had femoral vascular complications. The potential reduction in bleeding complications makes the brachial approach to stent implantation attractive in selected patients.
Authors:
R R Heuser; S S Mehta; R K Strumpf; R Ponder
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Publication Detail:
Type:  Case Reports; Journal Article    
Journal Detail:
Title:  Catheterization and cardiovascular diagnosis     Volume:  25     ISSN:  0098-6569     ISO Abbreviation:  Cathet Cardiovasc Diagn     Publication Date:  1992 Apr 
Date Detail:
Created Date:  1992-06-04     Completed Date:  1992-06-04     Revised Date:  2004-11-17    
Medline Journal Info:
Nlm Unique ID:  7508512     Medline TA:  Cathet Cardiovasc Diagn     Country:  UNITED STATES    
Other Details:
Languages:  eng     Pagination:  300-3     Citation Subset:  IM    
Affiliation:
Arizona Heart Institute, Phoenix 85064.
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MeSH Terms
Descriptor/Qualifier:
Aged
Angioplasty, Transluminal, Percutaneous Coronary / instrumentation*
Brachial Artery
Coronary Angiography
Coronary Disease / radiography,  therapy*
Female
Heart Catheterization / instrumentation*
Hemostatic Techniques*
Heparin / administration & dosage
Humans
Male
Stents*
Whole Blood Coagulation Time
Chemical
Reg. No./Substance:
9005-49-6/Heparin

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


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