ABSTRACT
Objective To explore the safety and feasibility of coronary angiography (CAG) via percutaneous left radial artery approach (LRA) compared with right radial artery approach (RRA) in aged patients, and determine whether LRA is a valid alternative for CAG. Methods A total of 502 consecutive patients who were aged 65 or older underwent diagnostic CAG were recruited and randomized to the LRA group (240 patients) or RRA group (262 patients). The study end points included total procedural duration, coronary time, fluoroscopy time, dose of radiation including cumulative air kerma and dose area product, contrast volume, and the incidence of vascular complications. Results Coronary procedural success rate was 96.2%(231/240) in LRA group and 96.2%(252/262) in RRA group. There was no significant difference (P>0.05). The radial cannulation time, fluoroscopy time, look through time, dose of radiation, contrast volume and the percentage of hydrophilic wire used in two group had no significant difference (P > 0.05). The catheter in place time in LRA was significantly shorter than that in RRA group:(2.7 ± 2.5) min vs. (3.3 ± 3.3) min, P=0.036). There was a trend toward shorter procedural duration in LRA group than that in RRA group, but there was no significant difference: (13.3 ± 6.1) min vs. (14.3 ± 6.2) min, P=0.075. Conclusions LRA approach has similar safety and feasibility in terms of performing coronary angiography compared with RRA.It seems to be a feasible alternative for CAG in aged patients.
ABSTRACT
Objective Cardiovascular mortality and morbidity is common in dialysis patients and fluid overload is the most important contributor. The aim of this study was to investigate the relationship between volume overload and hypertension in elderly continuous ambulatory peritoneal dialysis (CAPD) patients and effect of dietary salt restriction on blood pressure control. Methods Thirty-eight CAPD patients with age of 60 years old and over were enrolled in the present study. 38 patients with CAPD were restricted the intake of salt and fluid in stable CAPD patients for two months. Their body weight, extracellular water (ECW), intracellular water (ICW), total body water (TBW), blood pressure, serum albumin levels, urine volume and ultrafiltrate volume were measured before and after the dietary restriction. Bioimpedance analysis was used to assess their fluid status. ECW was normalized by patients' ideal weight (nECW). Results After dietary salt restriction, significant deceases in body weight 〔(60.5?10.3) kg vs (58.5?9.7) kg, P =0.000〕, ECW 〔(15.81?3.03) L vs (14.65?2.61) L, P =0.000〕 and systolic blood pressure 〔(134.0?18.3) mm Hg vs (128.3?21.0) mm Hg, P =0.05〕 were observed in 26 patients whereas the opposite changes were observed in the remaining 12 patients. A significant correlation was found between systolic blood pressure and nECW both before and after two months of dietary restriction ( r _ pre =0.379, P =0.019; r _ post =0.393, P =0.016) and between the changes in systolic blood pressure and changes in nECW ( r =0.514, P =0.001). Conclusions The present study suggests that there is a positive correlation between fluid status and blood pressure. Most of the elderly CAPD patients are fluid overloaded and that dietary salt restriction may be an effective way to control volume and blood pressure. However, the compliance of patients to dietary salt restriction can influence the effect.