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Cardiology Insights 2019
Journal of Heart and Cardiovascular Research
ISSN: 2576-1455
Page 32
March 07-08, 2019
Berlin, Germany
New Horizons in Cardiology
& Cardiologists Education
22
nd
International Conference on
Forearm approach – changing mindset
Bruno L R Faillace, Adriano O Tamazato, Leonardo S Coelho,
Evandro K P Ribeiro, Alexandre R Sposito, Fabio Conejo, Roger R Godinho
and
Rodrigo B Esper
Sancta Maggiore Hospital, Brazil
Statement
: Radial access offers several benefits to
patients, including reducing mortality in some settings.
To ensure this, the interventional cardiologist must want
to use that access path. To increase this technique use,
the physician first needs to change themindset. Although
slightlymore technically difficult and less supportive than
femoral access, it proved to be safer and feasible.
Methodology & Theoretical Orientation
: Several studies,
including RIVAL trial, have shown the superiority of radial
access in percutaneous coronary interventions. With this
information, after a meeting of the hospital interventional
cardiology team, it was decided to increase the use
preference of the forearm vessels (radial and ulnar
arteries of both arms) in all patients. In cases of puncture
site changing (cross over), the physicians would opt for
the other arm instead of femoral access. In individuals
with previous surgical revascularization (CABG), the
procedure would be performed by the left arm due to the
presence of left internal mammary artery. The data of all
patients are stored in a database.
Findings
: After changing the mindset, there was an
expressive increase in cases of forearm access. The
service average, which was already high, went from 80%
to 89%, reaching a rate of 96% in April 2018. The most
used access was the right radial and the cross over
rate was very low (3%). Using the forearm access, it is
possible to reduce the length of hospital stay after a
coronarography and to increase the rate of the same day
discharge after a percutaneous coronary intervention.
Thus, the concept of the radial lounge was implemented,
which provides a greater hospital stay.
Conclusion & Significance
: After a simple attitude of
changing the interventional cardiology team mindset,
the safer forearm vascular access can be offered to the
patients more frequently.
Recent Publications
1. Faillace B L R, Ribeiro H B, Campos C M, Truffa
A A M, Bernardi F L, Oliveira M D P, Mariani J
Jr., Marchini J F, Tarasoutchi F and Lemos P A
(2017) Potential of transcatheter aortic valve
replacement to improve post-procedure renal
function. Cardiovasc Revasc Med. 18(7):507-
511.
2. Bruno L R Faillace, Micheli Z Galon, Marcos
Danillo P Oliveira, Guy F A Prado Jr., Adriano
Bruno L R Faillace et al., J Heart Cardiovasc Res 2019, Volume 3
DOI: 10.21767/2576-1455-C1-002