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- Title
Wpływ użycia dominującej tętnicy przedramienia na siłę kończyny górnej po przezskórnych zabiegach inwazyjnych – badanie randomizacyjne.
- Authors
Lewandowski, Paweł
- Abstract
BACKGOUND The exact mechanism of hand strength reduction after coronary angiography with transradial access (TRA) or transulnar access (TUA) is unclear. AIMS This study aimed to assess the impact of use of a dominant or recessive forearm artery access on the incidence of the hand strength reduction at 30‑day observation. METHODS This prospective, single‑center, randomised trial included patients for CAG or PCI. Based on pre‑procedural ultrasound examination, the dominant artery was identified. Patients were classified to group A: dominant ulnar artery or group B: dominant radial artery, then randomized to dominant TRA or TUA (DAG – dominant artery group) or recessive TRA or TUA (RAG – recessive artery group). The primary endpoint was an incidence of hand’s strength reduction. The secondary endpoint was the incidence of subjective hand strength reduction, paresthesia and any hand’s pain. RESULTS Between 2016 and 2019, 200 patients (107 men, mean aged 68 ±8 years) were enrolled into the study. Patients were randomized to DAG or to RAG. Due to cross‑over between TRA and TUA, there were in DAG 115 (57%) patients, and in RAG 85 (43%) patients. Reduction of used hand strength occurred in 29% (n = 33) patients in DAG vs 47% (n = 40) in RAG, P = 0.008. Frequency of subjective hand strength reduction in DAG was 10% (n = 12), and in RAG 21% (n = 18); P = 0.03. Paresthesia occurred in DAG in 7% (n = 8), in RAG in 22% (n = 15); P = 002. Independent predictors of hand strength reduction were RAG OR, 0.45; 95% CI (0–24–0.82); P <0.01 and TRA OR, 1.87; 95% CI (1.01–34); P <0.05. CONCLUSIONS Use of a dominant artery as vascular access was associated with lower incidence of hand strength reduction.
- Subjects
CONFERENCES &; conventions; MUSCLE strength; MYOCARDIAL revascularization; TRANSLUMINAL angioplasty; RANDOMIZED controlled trials; ULNAR artery; RADIAL artery
- Publication
Polish Heart Journal / Kardiologia Polska, 2020, Vol 78, p94
- ISSN
0022-9032
- Publication type
Article