Finding the optimal access for proximal upper limb artery (PULA) interventions Lessons learned from the PULA multicenter registry /

Objective The multicenter proximal upper limb artery (PULA) Registry was created to study the optimal puncture sites for the interventions involving the subclavian, axillary, and innominate arteries. Background Little is known about the optimal vascular access for PULA interventions, despite the wel...

Teljes leírás

Elmentve itt :
Bibliográfiai részletek
Szerzők: Nardai Sándor
Zafirovska Biljana
Pataki Ákos András
Nemes Balázs
Tóth Júlia
Deák Mónika
Kedev Sasko
Bertrand Olivier Francois
Pirlet Charles
Merkely Béla Péter
Ruzsa Zoltán
Dokumentumtípus: Cikk
Megjelent: 2021
Sorozat:CATHETERIZATION AND CARDIOVASCULAR INTERVENTIONS 98 No. 7
Tárgyszavak:
doi:10.1002/ccd.29967

mtmt:32325524
Online Access:http://publicatio.bibl.u-szeged.hu/23385
LEADER 02998nab a2200337 i 4500
001 publ23385
005 20220201112333.0
008 220201s2021 hu o 0|| Angol d
022 |a 1522-1946 
024 7 |a 10.1002/ccd.29967  |2 doi 
024 7 |a 32325524  |2 mtmt 
040 |a SZTE Publicatio Repozitórium  |b hun 
041 |a Angol 
100 1 |a Nardai Sándor 
245 1 0 |a Finding the optimal access for proximal upper limb artery (PULA) interventions  |h [elektronikus dokumentum] :  |b Lessons learned from the PULA multicenter registry /  |c  Nardai Sándor 
260 |c 2021 
300 |a 1375-1382 
490 0 |a CATHETERIZATION AND CARDIOVASCULAR INTERVENTIONS  |v 98 No. 7 
520 3 |a Objective The multicenter proximal upper limb artery (PULA) Registry was created to study the optimal puncture sites for the interventions involving the subclavian, axillary, and innominate arteries. Background Little is known about the optimal vascular access for PULA interventions, despite the well-known technical complexity of these procedures. Methods We performed the retrospective analysis of consecutive patients treated for symptomatic steno-occlusive disease of the proximal upper limb arteries between January 2015 and December 2019 in three high-volume centers. Acute thrombotic occlusions were excluded from the study. Results Two hundred and seventy-two patients were treated for significant stenosis and 108 for total occlusion. The baseline patient's characteristics were similar, except for the higher median age of the stenotic patients: 68.5 years (31.1; 90.0) versus 64 years (38.0; 86.0) p = 0.0015. Successful revascularization rate was higher in the stenotic group 93.75% (255/272) versus 86.11% (93/108) p = 0.0230, while the procedure length 27 min (8; 133) versus 46 min (7; 140) p = 0.0001 and fluoroscopy times 439 s (92; 2993) versus 864 s (86; 4176) p = 0.0001 were higher in the occlusion group. The main adverse event rate was similarly low. Dual access was used more often to treat occlusions (60.19% (65/108) vs. 11.40% (31/272) p = 0.0001) without significantly increasing the complication rate. The safest access was ultrasound-guided distal radial artery puncture, significantly better than conventional radial access with 0% (0/31) versus 13.6% (18/131) p = 0.0253 complication. Conclusions The percutaneous revascularization of proximal upper limb arteries is a safe and effective. Dual access can be applied to increase treatment efficacy, without significantly compromising safety. 
650 4 |a Klinikai orvostan 
700 0 1 |a Zafirovska Biljana  |e aut 
700 0 1 |a Pataki Ákos András  |e aut 
700 0 1 |a Nemes Balázs  |e aut 
700 0 1 |a Tóth Júlia  |e aut 
700 0 1 |a Deák Mónika  |e aut 
700 0 1 |a Kedev Sasko  |e aut 
700 0 1 |a Bertrand Olivier Francois  |e aut 
700 0 1 |a Pirlet Charles  |e aut 
700 0 1 |a Merkely Béla Péter  |e aut 
700 0 1 |a Ruzsa Zoltán  |e aut 
856 4 0 |u http://publicatio.bibl.u-szeged.hu/23385/1/Nardai2021.pdf  |z Dokumentum-elérés