Evaluation of the Safety and Efficacy of Coronary Intervention through the Brachial Artery Compared to the Radial Artery in Elderly Patients with Different Extubation Times

Authors

  • Li-Yun Liu Cardiology Department, Beijing Aerospace General Hospital, 100076 Beijing, China
  • Fang Ren Cardiology Department, Beijing Aerospace General Hospital, 100076 Beijing, China
  • Yan-Lin Xing Cardiology Department, Beijing Aerospace General Hospital, 100076 Beijing, China
  • Qing-Rong Liu Cardiology Department, Beijing Aerospace General Hospital, 100076 Beijing, China
  • Qin-Yan Wu Cardiology Department, Beijing Aerospace General Hospital, 100076 Beijing, China
  • Ge Ren Cardiology Department, Beijing Aerospace General Hospital, 100076 Beijing, China
  • Qin-Wen Liao Cardiology Department, Beijing Aerospace General Hospital, 100076 Beijing, China
  • Lu Wang Cardiology Department, Beijing Aerospace General Hospital, 100076 Beijing, China
  • Feng Gan Cardiology Department, Beijing Aerospace General Hospital, 100076 Beijing, China

DOI:

https://doi.org/10.59958/hsf.7329

Keywords:

brachial artery puncture, radial artery puncture, coronary intervention, security, effectiveness

Abstract

Introduction: Percutaneous coronary intervention (PCI) is an important treatment for acute coronary syndrome. The main puncture paths of PCI include radial artery, brachial artery, and femoral artery. The aim of this study was to investigate the safety and efficacy of transbrachial intervention in elderly patients. Methods: According to intraoperative and postoperative nursing records, a retrospective analysis was performed for 70 elderly patients who underwent coronary intervention were divided into brachial artery A group (33 cases) and brachial artery B group (37 cases) according to immediate postoperative extubation compression dressing and 6 hours postoperative extubation compression dressing, and matched elderly patients who had successful transradial artery puncture in the same period as radial artery group (35 cases). The success rate of puncture and catheterization, arterial puncture time, total operation time, length of hospital stay, patient comfort score, incidence of arterial spasm and occlusion, subcutaneous ecchymosis and hematoma, epidermal blister occurrence, vagal reflex, pseudoaneurysm development, arteriovenous fistula formation, nerve damage risk assessment and osteofascial compartment syndrome were compared. Results: Compared with the radial artery group, the brachial artery group (group A and group B) had a higher success rate of puncture and catheterization (97.0% vs. 97.3% vs. 80.0%, p = 0.013), shorter arterial puncture time (2.45 ± 0.38 vs. 2.40 ± 0.35 vs. 3.40 ± 0.37, p = 0.000), and lower incidence of arterial spasm (0.0% vs. 0.0% vs. 34.3%, p = 0.000), arterial occlusion (0.0% vs. 0.0% vs. 14.3%, p = 0.005) and puncture site bleeding (12.1% vs. 5.6% vs. 40.0%, p = 0.001). The incidence of epidermal blister was higher in brachial artery A group than in brachial artery B group (24.2% vs. 2.7%, p = 0.003) or radial artery group (24.2% vs. 0%, p = 0.001), and the incidence of epidermal blister in brachial artery B group and radial artery group was not much different. There was no difference between the three groups in total operation time, length of hospital stay, comfort score, subcutaneous ecchymosis and hematoma, vagal reflex, pseudoaneurysm, arteriovenous fistula, nerve damage and osteofascial compartment syndrome. Conclusion: In elderly patients, coronary intervention through brachial artery is not inferior to radial artery.

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Published

2024-04-07

How to Cite

Liu, L.-Y. ., Ren, F. ., Xing, Y.-L. ., Liu, Q.-R. ., Wu, Q.-Y. ., Ren, G. . ., Liao, Q.-W. ., Wang, L. ., & Gan, F. (2024). Evaluation of the Safety and Efficacy of Coronary Intervention through the Brachial Artery Compared to the Radial Artery in Elderly Patients with Different Extubation Times. The Heart Surgery Forum, 27(4), E374-E380. https://doi.org/10.59958/hsf.7329

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