Featured Research

from universities, journals, and other organizations

Stenting To Prop Open Blocked Arteries: Will That Be Through An Arm Or A Leg?

Date:
July 22, 2008
Source:
Duke University Medical Center
Summary:
When it comes to stenting -- using metal tubes to prop open blocked arteries -- physicians are continuing to choose to gain entry to the circulatory system through an opening in the leg instead of the arm, even though the latter option appears to be safer, with fewer side effects.

When it comes to stenting -- using metal tubes to prop open blocked arteries -- physicians are continuing to choose to gain entry to the circulatory system through an opening in the leg instead of the arm, even though the latter option appears to be safer, with fewer side effects, say researchers at Duke Clinical Research Institute.

"Bleeding complications are reduced by 70 percent when interventional cardiologists go in through a radial artery in the wrist," says Dr. Sunil Rao, a cardiologist at Duke and the lead author of the study. "But our research shows that only a tiny fraction of stenting procedures are done this way. The study suggests that maybe it's time to change the way we practice."

Researchers reviewed data from 593,094 cases of percutaneous coronary intervention (PCI) in 606 hospitals across the U.S. included in the National Cardiovascular Data Registry from 2004 to 2007. They tracked the incidence of radial PCI (r-PCI) versus leg or femoral PCI (f-PCI) during that period and calculated which patients were more likely to get which option.

They found that the arm approach had gained favor over the four-year period, but still comprised only 1.3 percent of the total number of procedures. They also found that 40 percent of radial PCI was performed in only seven centers. Academic medical centers were more likely to be sites of higher r-PCI use than centers not affiliated with a college or university.

The data further revealed that r-PCI was more likely to be chosen as an approach for younger patients, those with significantly higher body mass index and patients with a higher prevalence of peripheral vascular disease

The study appears in the August issue of Journal of the American College of Cardiology: Cardiovascular Intervention. The study was funded by the National Cardiovascular Data Registry and the American College of Cardiology.

"The findings are somewhat surprising, given that numerous studies have shown that r-PCI is similarly successful to f-PCI, and that r-PCI can significantly lower risk of bleeding, especially among women, patients younger than 75 and people undergoing PCI for acute coronary syndrome," says Rao. He says previous studies have also shown that r-PCI may cost less because it can mean shorter time in the hospital for some patients.

A decade's worth of skilled training and technical advances in stent design has contributed to an increased safety profile for most stenting procedures. But Rao says bleeding can be a complication in about 10 percent of some procedures. While most bleeding is minor, such bleeding can be life-threatening in a small number of cases. PCI also carries a slight risk of death from blood clots or ruptured arterial walls.

Rao uses r-PCI himself almost exclusively, reserving f-PCI for three types of cases: where the catheter is too big to fit inside the radial artery; in cases where the patient has had coronary bypass surgery, which can complicate access from the left wrist; or in cases where there is no alternate blood flow to the hand.

Rao notes that r-PCI is the preferred option in Europe. He says slower acceptance of the technique in the United States may be due to normal resistance to change, resistance to having to master a new learning curve and a lack of industry effort to market new devices specially designed for r-PCI.

Colleagues contributing to the study include senior author Eric Peterson, M.D., Fang-Shu Ou, M.S., Tracy Wang, M.D., and Matthew Roe, M.D., from the Duke Clinical Research Institute; Ralph Brindis, M.D., from the Oakland Kaiser Hospital and John Rumsfeld, M.D., from the Denver VA Medical Center.


Story Source:

The above story is based on materials provided by Duke University Medical Center. Note: Materials may be edited for content and length.


Cite This Page:

Duke University Medical Center. "Stenting To Prop Open Blocked Arteries: Will That Be Through An Arm Or A Leg?." ScienceDaily. ScienceDaily, 22 July 2008. <www.sciencedaily.com/releases/2008/07/080718180705.htm>.
Duke University Medical Center. (2008, July 22). Stenting To Prop Open Blocked Arteries: Will That Be Through An Arm Or A Leg?. ScienceDaily. Retrieved August 22, 2014 from www.sciencedaily.com/releases/2008/07/080718180705.htm
Duke University Medical Center. "Stenting To Prop Open Blocked Arteries: Will That Be Through An Arm Or A Leg?." ScienceDaily. www.sciencedaily.com/releases/2008/07/080718180705.htm (accessed August 22, 2014).

Share This




More Health & Medicine News

Friday, August 22, 2014

Featured Research

from universities, journals, and other organizations


Featured Videos

from AP, Reuters, AFP, and other news services

Drug Used To Treat 'Ebola's Cousin' Shows Promise

Drug Used To Treat 'Ebola's Cousin' Shows Promise

Newsy (Aug. 21, 2014) An experimental drug used to treat Marburg virus in rhesus monkeys could give new insight into a similar treatment for Ebola. Video provided by Newsy
Powered by NewsLook.com
Two US Ebola Patients Leave Hospital Free of the Disease

Two US Ebola Patients Leave Hospital Free of the Disease

AFP (Aug. 21, 2014) Two American missionaries who were sickened with Ebola while working in Liberia and were treated with an experimental drug are doing better and have left the hospital, doctors say on August 21, 2014. Duration: 01:05 Video provided by AFP
Powered by NewsLook.com
Cadavers, a Teen, and a Medical School Dream

Cadavers, a Teen, and a Medical School Dream

AP (Aug. 21, 2014) Contains graphic content. He's only 17. But Johntrell Bowles has wanted to be a doctor from a young age, despite the odds against him. He was recently the youngest participant in a cadaver program at the Indiana University NW medical school. (Aug. 21) Video provided by AP
Powered by NewsLook.com
American Ebola Patients Released: What Cured Them?

American Ebola Patients Released: What Cured Them?

Newsy (Aug. 21, 2014) It's unclear whether the American Ebola patients' recoveries can be attributed to an experimental drug or early detection and good medical care. Video provided by Newsy
Powered by NewsLook.com

Search ScienceDaily

Number of stories in archives: 140,361

Find with keyword(s):
Enter a keyword or phrase to search ScienceDaily for related topics and research stories.

Save/Print:
Share:

Breaking News:
from the past week

In Other News

... from NewsDaily.com

Science News

Health News

Environment News

Technology News



Save/Print:
Share:

Free Subscriptions


Get the latest science news with ScienceDaily's free email newsletters, updated daily and weekly. Or view hourly updated newsfeeds in your RSS reader:

Get Social & Mobile


Keep up to date with the latest news from ScienceDaily via social networks and mobile apps:

Have Feedback?


Tell us what you think of ScienceDaily -- we welcome both positive and negative comments. Have any problems using the site? Questions?
Mobile: iPhone Android Web
Follow: Facebook Twitter Google+
Subscribe: RSS Feeds Email Newsletters
Latest Headlines Health & Medicine Mind & Brain Space & Time Matter & Energy Computers & Math Plants & Animals Earth & Climate Fossils & Ruins