PMID: 2510675Sep 1, 1989Paper

Transluminal coronary angioplasty using a percutaneous axillary route with an arterial sheath

Archives des maladies du coeur et des vaisseaux
B ValeixJ C Nebunu

Abstract

Out of 1400 percutaneous transluminal coronary angioplasties (PTCA), 23 (1.6 p. 100) were performed by the left percutaneous axillary approach because the bifemoral approach could not be used. There were 18 patients (17 men, 1 woman) with a mean age of 58 years. The coronary vessels dilated were the anterior interventricular artery (n = 4), the circumflex artery (n = 9) and the right coronary artery (n = 10), i.e. a total of 25 stenoses. The success rate in procedures was 83 p. 100 (19/23), and the primary success rate in patients was 83.3 p. 100 (15/18): Despite a good initial result, one patient developed inferior myocardial infarction as a result occlusion of a dominant distal circumflex artery, due to protamine administration immediately after the procedure. Another failure ascribable to the approach was due to selective catheterization being impossible. The mean duration of TCA was 38 min. In every cases the arterial introducer was withdrawn after neutralization with protamine. There were 4 cases of restenosis (25 p. 100) :3 were treated by a second PTCA using the percutaneous axillary approach and 1 by surgery. The method has the following disadvantages: (1) neutralization with protamine is mandatory (we had 1 case of occ...Continue Reading

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