Segurança e eficácia do acesso radial na realizaç ão de procedimentos coronários diagnósticos e terapêuticos em mulheres

Abstract

Female gender is an independent predictor of vascular complications after invasive coronary procedures. While reducing the risk of bleeding related to the puncture site, radial access in women might be particularly beneficial in reducing adverse events. Method: Consecutive female patients undergoing diagnostic and therapeutic coronary procedures using radial access were enrolled in a prospective registry. The success of the technique, the procedure and fluoroscopy times, vascular complications and severe periprocedural cardiovascular adverse events were analyzed. In addition, a comparative analysis between women < 65 and > 65 years old was carried out to determine the applicability of the technique among elderly patients. Results: Between May 2008 and September 2009, 988 women underwent invasive coronary procedures using the radial access. Mean age was 62.5 years, and 32.4% were diabetics. The success rate was 97.1%. There was a low incidence of complications, including asymptomatic occlusion of the radial artery (2.8%), hematomas (2.4%), and severe bleeding (0.2%). Except for a longer duration of fluoroscopy while performing angioplasties, women > 65 years showed similar success rates compared to those < 65 years. Conclusions: The use of radial access for coronary procedures in women showed a high success rate, reduced number of adverse cardiovascular events, and virtually no severe bleeding related the puncture site.