RESUMO
Background and Objective: Due to increase in number of cardiac catheterization procedures safety concerns is an issue nowadays. Multiple diagnostic modalities use radiations, which also put a patient at higher cumulative radiation exposure. Therefore steps should be taken to minimize radiation exposure during cardiac catheterization. Hence determination of factors which prolong FT will result in better understanding of problem.This retrospective study was undertaken to determine factors responsible for prolong fluoroscopy time in patients undergoing coronary artery catheterization
Methods: This retrospective study was conducted at catheterization Laboratory National Institute of Cardiovascular Diseases, Karachi from June 2014 to June 2015. Patients of either gender, aged between 18 to 90 years undergoing cardiac catheterization procedures were included. Radiation exposure time was measured in terms of fluoroscopy time
Results: A total of 957 patients were included in this study out of which 731 were of diagnostic Coronary Angiograms [CA] and 226 were of Percutaneous Coronary Intervention [PCI]. The mean age of the study participants was 54.12+/-10.89 years and majority 734[76.6%] were male. Mean fluoroscopy time [FT] in the patients subjected to PCI was 9.61+/-6.07 minutes while in cases for CA 4.17+/-4.13 minutes. FT for CA was observed significantly dependent on procedural access, operator's experience, and LV angiogram. While FT for PCI was found dependent on number of stents deployed during the procedure
Conclusion: For invasive coronary angiographic procedures radial route increased fluoroscopy time. For percutaneous coronary intervention femoral and radial route fluoroscopy time were not significantly different
RESUMO
Object: The object of this study was to compare the outcome of primary PCI of ostial versus non ostial occlusion of LAD artery
Materials and Methods: This observational study was conducted at National Institute of Cardivascular Diseases Karachi, Pakistan from January 1[st], 2008 to December 31[st], 2008. A total of 70 patients presented to the catheterization laboratory for primary PCI of LAD artery in whom baseline coronary angiogram showed acute occlusion of left anterior descending artery were enrolled for the study. All patients received Aspirin, Clopidogrel and Platelet Glycoprotein IIB IIIA inhibitor. Patients were followed at one month, 3 months and 6 months
Results: Out of 70 cases 50 had nonostial and 20 had ostial occlusion. Baseline characteristics were similar between both groups. Stenting was done in 95% of all patients and was similar in patients with ostial or nonostial narrowing. Procedural success was the same for ostial and nonostial Primary PCI [100% vs. 96%]. Six months event free survival was also similar in both groups [75% vs. 76%]. Total event rate and mortality was also same in both groups [25% vs. 24% and 10% vs. 10%]
Conclusion: Primary PCI of ostial LAD occlusion with suitable anatomy is as safe and similar as non ostial LAD occlusion and optimal results can be achieved in this high risk group of patients in a developing country at a tertiary care public sector hospital. To validate our results further studies with larger cohort are needed