Indian heart journal · 2026
Pigtail assisted tracking of guide catheter during transradial coronary angioplasty on forearm complications: prospective randomized trial.
СтатьяРандомизированное исследованиеНазвание и аннотация: Перевод в очереди
Обработка статьи · этапы, ошибки и управление
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Garg Naveen, Yadav Mukesh Kumar, Kapoor Aditya, Tewari Satendra, Khanna Roopali, Sahu Ankit, Khare Harsit, Katheria Arpita, Nazir Arshad
Аннотация
OBJECTIVES: During transradial percutaneous intervention (PCI), sharp edge of guide catheter tip may produce "razor blade effect" leading to radial vascular injury. Pigtail assisted tracking (PAT) technique has been described to overcome it, but has not been systematically evaluated. We prospectively evaluated the safety and efficacy of PAT technique in transradial PCI.
METHODS: Consecutive patients undergoing transradial-PCI were randomized into two groups (Group 1: transradial navigation using PAT technique, Group 2: transradial navigation without PAT technique). Patients were observed for forearm complications and radial artery patency was determined by vascular Doppler at 48 h. Primary end point was the composite incidence of radial artery spasm, angiographic radial artery injury, forearm hematoma and radial artery occlusion (RAO). Secondary end points were incidence of each of these individual variables. Predictors of forearm complications were determined by multivariate analysis.
RESULT: Total 260 patients were finally included (130 patients in each group). Baseline and procedural characteristics were comparable in both groups. Majority [158 (60.8%) patients] had acute coronary syndrome. Primary outcome was significantly reduced by the PAT technique [15 (11.5%) vs. 33 (25.4%) patients; p = 0.004]. Individual outcomes were also significantly less in Group 1 [radial artery spasm 12 (9.2%) vs. 28 (21.5%), p = 0.006; angiographic radial artery injury 4 (3.1%) vs. 12 (9.2%), p = 0.04; forearm hematoma 6 (4.6%) vs. 17 (13.1%), p = 0.01; RAO 4 (3.1%) vs. 13 (10.0%), p = 0.02]. PCI without PAT technique and low body weight emerged as independent predictor for forearm complications.
CONCLUSION: PAT technique is safe and significantly reduces the forearm complications.
METHODS: Consecutive patients undergoing transradial-PCI were randomized into two groups (Group 1: transradial navigation using PAT technique, Group 2: transradial navigation without PAT technique). Patients were observed for forearm complications and radial artery patency was determined by vascular Doppler at 48 h. Primary end point was the composite incidence of radial artery spasm, angiographic radial artery injury, forearm hematoma and radial artery occlusion (RAO). Secondary end points were incidence of each of these individual variables. Predictors of forearm complications were determined by multivariate analysis.
RESULT: Total 260 patients were finally included (130 patients in each group). Baseline and procedural characteristics were comparable in both groups. Majority [158 (60.8%) patients] had acute coronary syndrome. Primary outcome was significantly reduced by the PAT technique [15 (11.5%) vs. 33 (25.4%) patients; p = 0.004]. Individual outcomes were also significantly less in Group 1 [radial artery spasm 12 (9.2%) vs. 28 (21.5%), p = 0.006; angiographic radial artery injury 4 (3.1%) vs. 12 (9.2%), p = 0.04; forearm hematoma 6 (4.6%) vs. 17 (13.1%), p = 0.01; RAO 4 (3.1%) vs. 13 (10.0%), p = 0.02]. PCI without PAT technique and low body weight emerged as independent predictor for forearm complications.
CONCLUSION: PAT technique is safe and significantly reduces the forearm complications.