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Search Results: 1 - 10 of 551967 matches for " M?nica Vieira Athanazio de;Mattos "
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Seguran?a e eficácia do acesso radial na realiza??o de procedimentos coronários diagnósticos e terapêuticos em mulheres
Andrade, Pedro Beraldo de;Tebet, Marden André;Andrade, Mnica Vieira Athanazio de;Mattos, Luiz Alberto;Labrunie, André;
Revista Brasileira de Cardiologia Invasiva , 2009, DOI: 10.1590/S2179-83972009000400007
Abstract: background: female gender is an independent predictor of vascular complications after invasive coronary procedures. while reducing the risk of bleeding related to the puncture site, radial access in women might be particularly beneficial in reducing adverse events. method: consecutive female patients undergoing diagnostic and therapeutic coronary procedures using radial access were enrolled in a prospective registry. the success of the technique, the procedure and fluoroscopy times, vascular complications and severe periprocedural cardiovascular adverse events were analyzed. in addition, a comparative analysis between women < 65 and > 65 years old was carried out to determine the applicability of the technique among elderly patients. results: between may 2008 and september 2009, 988 women underwent invasive coronary procedures using the radial access. mean age was 62.5 years, and 32.4% were diabetics. the success rate was 97.1%. there was a low incidence of complications, including asymptomatic occlusion of the radial artery (2.8%), hematomas (2.4%), and severe bleeding (0.2%). except for a longer duration of fluoroscopy while performing angioplasties, women > 65 years showed similar success rates compared to those < 65 years. conclusions: ts, and virtually no severe bleeding related the puncture site.
Registro prospectivo de avalia??o da seguran?a e eficácia da técnica ulnar na realiza??o de procedimentos coronários
Andrade, Pedro Beraldo de;Tebet, Marden André;Andrade, Mnica Vieira Athanazio de;Mattos, Luiz Alberto;Labrunie, André;
Revista Brasileira de Cardiologia Invasiva , 2008, DOI: 10.1590/S2179-83972008000300012
Abstract: background: the use of the transradial approach is associated with low rates of complications at the puncture site, reduced costs, shorter hospital stay and is more confortable to the patient. however, its is not feasible in 5%15% of the cases due to significant anatomic variations, vessel spasms and negative results in the allen's test. the aim of this study was to evaluate the safety and efficacy of the transulnar access as an alternative approach in these situations. methods: coronary procedures performed through the transulnar approach were included in a prospective registry. we evaluated the success rates, defined as adequate coronary opacity in coronary angiography or a percutaneous coronary intervention (pci) with residual stenosis < 30%, with no need to change the access site; procedure and fluoroscopy times and the rate of in-hospital and 30-day complications. results: between may 2007 and may 2008, 102 coronary procedures were included in the registry. the mean age was 61 ± 11 years, 53% were female patients and 34% were diabetic. success rates were 94.5% and 100% for coronary angiography and pci, respectively. there was a low rate of complications, including 2% of asymptomatic occlusion of the ulnar artery and 1% of hematoma not requiring vascular repair or blood transfusion. conclusions: the use of transulnar access in coronary procedures is safe and efficient, with high success rates and virtually no complications related to the puncture site. it is a good alternative for those experienced with the transradial approach.
Interven??o coronariana percutanea primária pelo acesso transulnar: seguran?a e eficácia
Andrade, Pedro Beraldo de;Tebet, Marden André;Andrade, Mnica Vieira Athanazio de;Labrunie, André;Mattos, Luiz Alberto Piva e;
Arquivos Brasileiros de Cardiologia , 2008, DOI: 10.1590/S0066-782X2008001600017
Abstract: the transradial approach is safe and effective for coronary procedures. however, its use may be compromised in cases of variations in radial artery anatomy, spasms, and negative allen's test. the transulnar approach emerges as a viable alternative to transradial approach. we report on a patient who underwent primary angioplasty via ulnar artery without ischemic hand complications despite prior occlusion of the ipsilateral radial artery.
Utiliza??o do acesso radial elimina a ocorrência de sangramento grave relacionado ao sítio de pun??o após interven??o coronária percutanea primária
Andrade, Pedro Beraldo de;Tebet, Marden André;Silva, Felipe Souza Maia da;Andrade, Mnica Vieira Athanazio de;Mattos, Luiz Alberto;Labrunie, André;
Revista Brasileira de Cardiologia Invasiva , 2010, DOI: 10.1590/S2179-83972010000400006
Abstract: background: transradial approach is associated with a low incidence of vascular complications. this peculiarity makes it useful in acute coronary syndromes, where aggressive antiplatelet and antithrombotic therapy is frequently used. the aim of this study was to evaluate the efficacy and safety of transradial approach in primary percutaneous intervention, where delays in achieving reperfusion resulting from technical difficulties are unacceptable. method: registry including consecutive patients undergoing primary percutaneous intervention by transradial approach. the efficacy endpoints were in-hospital mortality, door-to-balloon time, final timi iii flow and access site crossover. safety was assessed by the rate of major bleeding and complications related to the puncture site. results: from february 2007 to november 2009, 211 patients underwent primary percutaneous intervention, 201 of them by transradial approach. mean age was 59 years, 27.4% were female and 22.4% had diabetes mellitus. final timi iii flow was achieved in 91.5% of patients, st segment resolution > 50% in 88.5%, with a crossover rate of 1.5%. in-hospital mortality was 4.5% and the rate of major bleeding was 1%, with one episode of upper gastrointestinal bleeding and a decrease in hemoglobin > 5 g/dl. vascular complications related to the puncture site were limited to 3 cases of type ii hematoma and 2 cases of type iii hematoma, with no clinical impact and spontaneous resolution. conclusion: the transradial approach, performed by operators familiarized with the technique, is a safe and effective alternative for primary percutaneous coronary intervention, with virtually no major vascular complications related to the puncture site.
Valida??o de protocolo para obten??o de hemostasia com dispositivo de compress?o radial TR BandTM após interven??o coronária percutanea
Andrade, Mnica Vieira Athanazio de;Andrade, Pedro Beraldo de;Barbosa, Robson Alves;Tebet, Marden André;Silva, Felipe Souza Maia da;Labrunie, André;Mattos, Luiz Alberto;
Revista Brasileira de Cardiologia Invasiva , 2011, DOI: 10.1590/S2179-83972011000200014
Abstract: background: the use of the transradial approach has increased steadily, thanks to the availability of consistent data supporting their safety and effectiveness. although radial artery occlusion is a rare and mostly asymptomatic complication, its occurrence prevents reuse of radial access in future procedures. methods: prospective study assessing consecutive patients undergoing percutaneous coronary intervention (pci) by radial access using the tr bandtm radial compression device to obtain hemostasis and maintain anterograde flow, according to the new protocol proposed to handle the device. results: from february to march 2011, 30 patients undergoing pci using the tr bandtm to obtain hemostasis after the procedure were included in the study. twenty-seven (90%) patients reported comfort and no wrist pain; arterial oxygen saturation remained > 90% in 29 (96.6%) patients; there was no episode of arterial occlusion, and pulse was present after compression and at discharge in all cases; and hemostasis was obtained within the interval and with the removal of pre-established volume of air in 26 (86.7%) patients. conclusions: the tr bandtm radial compression device is a safe and effective strategy to achieve hemostasis, maintaining anterograde flow after pci. the use of the protocol proposed for the management of the device proved to be feasible and easy to apply, without demanding frequent assessments that may discourage a more extensive use of this device.
Impacto da utiliza??o do acesso radial na ocorrência de sangramento grave entre idosos submetidos a interven??o coronária percutanea
Andrade, Pedro Beraldo de;Tebet, Marden André;Andrade, Mnica Vieira Athanazio de;Barbosa, Robson Alves;Mattos, Luiz Alberto;Labrunie, André;
Revista Brasileira de Cardiologia Invasiva , 2012, DOI: 10.1590/S2179-83972012000100005
Abstract: background: the occurrence of major bleeding after percutaneous coronary intervention (pci) is associated to higher morbidity and mortality, and advanced age is one of its main predictors. the aim of this analysis was to evaluate the impact of the use of the transradial approach in the incidence of bleeding complications in elderly patients undergoing pci. methods: consecutive and controlled registry including patients over 60 years of age undergoing pci by transradial approach. angiographic procedure success, technical failure, and the incidence of ischemic adverse events and major bleeding were evaluated. results: between may 2008 and december 2010, 707 elderly patients underwent pci, of whom 635 (89.8%) used the transradial approach. mean age was 69.9 ± 7.2 years, 11.5% were > 80 years of age, 39.7% were female and 30.9% had diabetes mellitus. acute ischemic syndrome accounted for 72% of clinical indications. the angiographic success rate was 96.8% with a crossover rate of 2.8%. the in-hospital mortality rate was 2.4%, myocardial infarction occurred in 0.9%, stroke in 0.3% and stent thrombosis in 0.9%. hematomas were reported in 1.6% of procedures, with a major bleeding rate of 0.8%. conclusions: in elderly patients undergoing pci, representing the real-world practice and at a high risk for bleeding, the use of the transradial approach was associated with a low major bleeding rate.
Seguran?a e eficácia da cateteriza??o cardíaca direita e esquerda pelo acesso transradial comparado ao transfemoral: experiência inicial
Tebet, Marden Andre;Andrade, Pedro Beraldo de;Andrade, Mnica Vieira Athanazio de;Gentile, Milena;Mattos, Luiz Alberto Piva e;Labrunie, André;
Revista Brasileira de Cardiologia Invasiva , 2008, DOI: 10.1590/S2179-83972008000300013
Abstract: background: right and left heart catheterization (rlc) is a limitation on the use of the transradial technique (trt). however, recent studies have shown that the procedure can be safely performed with the use of a forearm venous access. in this study, it was evaluated the use of this new approach compared with the transfemoral technique (tft). method: between january 2006 and june 2008, 70 patients were submitted to rlc. from september 2007 on, trt was adopted as the first choice technique. venous access in the trt was obtained by puncturing a forearm vein using a jelcotm 20 catheter. this study aimed to evaluate trt safety and effectiveness compared with tft through the procedure success rates, occurrence of in-hospital complications related to the puncture site, as well as procedure and fluoroscopy times. results: among the 70 patients evaluated, 35 had undergone the procedure through trt and 35 through tft. the groups were well matched, with no significant differences in baseline clinical characteristics, except for the higher percentage of patients using oral anticoagulant in the trt group (p = 0.005). the procedure success rate was 97.1% in trt and 100% in tft (p > 0.99). in one case in the trt group it was not possible to advance the introducer through the forearm venous access, and the technique was converted to tft. the mean duration of the procedure was significantly shorter in the trt group compared with the tft group (28.28 ± 10.21 min vs. 42.85 ± 20.33 min; p = 0.0004). the fluoroscopy time was 6.17 ± 2.42 min in trt and 8.39 ± 6.38 min in tft (p = 0.060). there were 6 cases of minor bleeding from the puncture site in the tft group and none in the trt group (p = 0.024). conclusions: performing rlc using trt was safe and effective. it is a useful alternative to standard tft approach, reducing procedure duration, vascular complications, and possibly procedure costs.
Fondaparinux em interven??o coronária percutanea no tratamento da síndrome coronária aguda
Andrade, Pedro Beraldo de;Tebet, Marden André;Nogueira, Ederlon Ferreira;Andrade, Mnica Vieira Athanazio de;Barbosa, Robson Alves;Labrunie, André;Mattos, Luiz Alberto;
Revista Brasileira de Cardiologia Invasiva , 2012, DOI: 10.1590/S2179-83972012000200008
Abstract: background: fondaparinux is considered an agent with a well-established safety and efficacy profile in the treatment of non-st segment elevation acute coronary syndromes, but when used alone, is associated to a higher incidence of thrombotic complications during invasive coronary procedures, requiring the supplementation of an anti-iia agent. this study aimed to evaluate the efficacy and safety of percutaneous coronary intervention (pci) in patients with non-st segment elevation acute coronary syndromes previously treated with fondaparinux. methods: prospective, controlled registry enrolling 127 consecutive patients submitted to an early invasive stratification during treatment with fondaparinux, with supplementation of intravenous unfractionated heparin at a dose of 85 u/kg at the time of pci. results: the rate of the composite primary endpoint including death, acute myocardial infarction, stroke, stent thrombosis or emergency myocardial revascularization was 3.2%. the cumulative incidence of major bleeding and vascular complications was 3.2%. there were no cases of guide-catheter thrombosis or abrupt vessel closure. conclusions: pci in patients with acute coronary syndromes receiving fondaparinux is associated with a low rate of major adverse cardiovascular ischemic events and severe hemorrhagic complications. supplementation of unfractionated heparin during the invasive procedures eliminates the risk of catheter-related thrombosis.
Coronariografia via transradial: curva de aprendizagem, avaliada por estudo multicêntrico
Labrunie, André;Tebet, Marden Andre;Andrade, Pedro Beraldo de;Andrade, Mnica Vieira Athanazio de;Conterno, Lucieni de Oliveira;Mattos, Luiz Alberto;Carvalho, Fábio Cardoso de;Bregagnollo, Edson Antonio;
Revista Brasileira de Cardiologia Invasiva , 2009, DOI: 10.1590/S2179-83972009000100015
Abstract: background: femoral access for diagnostic and therapeutic coronary procedures has been the dominant approach worldwide, despite an increased risk of vascular and hemorrhagic complications. the transradial approach is a more recent technique used to reduce these complications, providing more comfort and reducing hospitalization costs. however, it is associated with an inherent learning curve. the aim of the study was to evaluate transradial coronary angiography performed by inexperienced operators and compare the success and complication rates of this technique with the classical approach (sones and femoral), analyzing the influence of the learning curve. methods: multicenter, randomized study, in 14 hospitals in s?o paulo state in a one-year period. one thousand patients were randomized to the transradial or classical techniques. results: the success rate was similar in both groups (97.8% vs. 98.5%; p = 0.47). sones technique was used in 95.2% of the procedures in the classical technique group. the number of catheters used, the duration of the procedure and x-ray exposure were greater in the transradial group (p < 0.001). there were no differences in the major cardiac adverse events (death, infarct and stroke), and vascular and bleeding complications. operators who had performed over 100 procedures using the transradial approach (3 centers/5 operators) had a lower failure rate (1.6% vs. 3.6%; p = 0.04). conclusion: a learning period to perform coronary procedures using the transradial approach is required, but it is not associated with an increased risk of procedure failure or vascular complications compared with sones or femoral approaches.
Impacto da transferência inter-hospitalar nos resultados da interven??o coronária percutanea primária
Andrade, Pedro Beraldo de;Tebet, Marden André;Nogueira, Ederlon Ferreira;Rinaldi, Fábio Salerno;Esteves, Vinícius Cardozo;Andrade, Mnica Vieira Athanazio de;Barbosa, Robson Alves;Labrunie, André;Mattos, Luiz Alberto;
Revista Brasileira de Cardiologia Invasiva , 2012, DOI: 10.1590/S2179-83972012000400004
Abstract: background: delays resulting from the transfer to perform primary percutaneous coronary intervention (pci) have a negative impact on the benefits of the procedure. methods: prospective registry aimed at comparing the results of primary pci in patients with st-segment elevation myocardial infarction (stemi) admitted or transferred to an interventional cath lab equipped hospital. results: between february 2009 and december 2011, 319 patients were included in the study with mean age of 59.8 ± 12 years, 28.5% were female and 22.3% were diabetics. patients transferred for primary pci (n = 201) had longer door-to-balloon time (86.4 ± 26.6 min vs 69 ± 22.6 min; p < 0.0001), a non-significant decrease in st-segment elevation resolution (83.5% vs 90.4%; p = 0.18), final timi 3 flow (90.1% vs 94.1%; p = 0.30), myocardial blush grade 3 (74.3% vs 78.8%; p = 0.22) and angiographic success (90.1% vs 94.1%; p = 0.30), and a non-significant increase in major bleeding (2% vs 0.9%; p = 0.20) and hospital mortality (6.5% vs 4%; p = 0.29). conclusions: the referral of patients with stemi directly to an interventional cath lab equipped hospital is associated with shorter door-to-balloon time and non-significant improvement of reperfusion markers and mortality.
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