Percutaneous Coronary Intervention in Nepal

Authors

  • A. Maskey Shahid Gangalal National Heart Centre, Kathmandu, Biratnagar, Nepal
  • M. Bhattarai National Academy of Medical Sciences, Bir Hospital, Kathmandu, Biratnagar, Nepal
  • L. Dubey College of Medical Science, Chitwan, Biratnagar, Nepal
  • B. Rawat Norvic International Hospital, Kathmandu, Biratnagar, Nepal
  • N. Shrestha Neuro Cardio and Multispeciality Hospital, Biratnagar, Nepal
  • R. Malla Shahid Gangalal National Heart Centre, Kathmandu, Biratnagar, Nepal
  • R. Rajbhandari Shahid Gangalal National Heart Centre, Kathmandu, Biratnagar, Nepal
  • Y.K.D. Bhatt Shahid Gangalal National Heart Centre, Kathmandu, Biratnagar, Nepal
  • H. Nepal Shahid Gangalal National Heart Centre, Kathmandu, Biratnagar, Nepal
  • R. Pandey Shahid Gangalal National Heart Centre, Kathmandu, Biratnagar, Nepal

DOI:

https://doi.org/10.12970/2311-052X.2015.03.01.4

Keywords:

Percutaneous coronary intervention (PCI), Femoral access, Radial access

Abstract

Introduction: Percutaneous coronary intervention (PCI) is an important aspect of management of ischemic heart disease. The use of PCI has expanded with importance on minimizing post-procedural vascular and bleeding complications while maintaining procedural success. The radial artery has emerged as an alternative to the femoral artery for the access sitefor the procedure.

Objectives: The main objective of the study was to assess the trend of PCI, procedural outcome and complications.

Methods: This is a retrospective study which included four thousand two hundred and eighty eight patients who had underwent percutaneous coronary intervention during the study period of ten years from 2002 to 2012. The data on demographic profile, angiographic characteristics, outcome and complications of the procedure were analyzed.

Results: The mean age of the patients was50 ± 10.5 years ranging from 21 to 91 years. The79.5% (3409) were male and 20.5% (879) were female. The 75.3 % (3228) of the PCI were elective procedure. The 94.38% (4047) of the patient had single vessel PCI and 241(5.62%) had multivessels PCI. The PCI to LAD was the most common in 2153 (47.43%) followed by RCA 1401(30.87%) and then LCX 957 (21.08%). Overall success rate of the procedure was 95.03%. The mortality was observed in 1.07% (46) of the patients. The use of radial artery access for the PCI has a rising trend over years. The 43.5% of the procedure were performed from the radial access in 2012.

Conclusion: Percutaneous coronary intervention in Nepal is increasing every year with accepted success rate and complication. With experience more complex cases are being done. Radial PCI has increasing trend.

References

Gruntzig A. Transluminal dilatation of coronary artery stenosis. Lancet 1978; 1: 263. http://dx.doi.org/10.1016/S0140-6736(78)90500-7

Stettler C, Wandel S, Allemann S, et al. Outcomes associated with drug -eluting and bare-metal stents: a collaborative meta-analysis. Lancet 2007; 370: 937-48. http://dx.doi.org/10.1016/S0140-6736(07)61444-5

Venkitachalam L, Kip KE, Selzer F, et al. Twenty-Year Evolution of Percutaneous Coronary Intervention and Its Impact on Clinical Outcomes: A Report From the National Heart, Lung, and Blood Institute. Circ CardiovascInterv 2009; 2: 6-13. http://dx.doi.org/10.1161/CIRCINTERVENTIONS.108.825323

Rao SV, Mauricio G, David EK, et al. The Transradial Approach to Percutaneous Coronary Intervention Historical Perspective, Current Concepts, and Future Directions. J Am Coll Cardiol 2010; 55(20): 2187-95. http://dx.doi.org/10.1016/j.jacc.2010.01.039

Campeau L. Percutaneous radial artery approach for coronary angioplasty. Cathet Cardiovasc Diagn 1989; 16: 3-7. http://dx.doi.org/10.1002/ccd.1810160103

Kiemeneij F, et al. Transradial artery coronary angioplasty. Am Heart J 1989; 129: 1-7. http://dx.doi.org/10.1016/0002-8703(95)90034-9

Ronald PC, Tremmel JA, Rao S, et al. Transradial Arterial Access for Coronary and Peripheral Procedures: Executive Summary by the Transradial Committee of the SCAI Catheterization and Cardiovascular Interventions 2011; 1-17.

Tewari S, Sharma N, Kapoor A, et al. Comparison of transradial and transfemoral artery approach for percutaneous coronary angiography and angioplasty: A retrospective seven-year experience from a north Indian center. Indian Heart Journal 2013; 65: 378-87.

Khan M, Qadir F, Hanif B, et al. To determine the safety and success of transradial coronary angiography and angioplasty — A local experience. J Pak Med Assoc 2010; 10(60): 809-13.

Louvard Y, Pezzano M, Scheers L, et al. Coronary angiography by a radial approach: feasibility, learning curve. One operator's experience. Arch Mal Coeur Vaiss 1998; 91: 209-15.

Jolly SS, Yusuf S, Cairns J, Niemelä, et al. Radial versus femoral access for coronary angiography and intervention in patients with acute coronary syndromes (RIVAL): a randomised, parallel group, multicentre trial. Lancet 2011; 377: 1409-20. http://dx.doi.org/10.1016/S0140-6736(11)60404-2

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Published

2015-08-03

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