Key result
Severe left subclavian tortuosity is linked to ~22 minutes longer left radial PCI times.
Why the study?
Patients with acute coronary syndrome receiving radial access PCI experience fewer adverse events, but the relationship between left subclavian artery angle and PCI procedural time was unknown.
Does the angle of the left subclavian artery affect procedural time during percutaneous coronary intervention via the left radial approach in patients with acute coronary syndrome?
Observational (n=124)
No
Does the angle of the left subclavian artery affect procedural time during percutaneous coronary intervention via the left radial approach in patients with acute coronary syndrome?
A sharper left subclavian artery angle (<70 degrees) is significantly associated with longer procedural and sheath-to-first-balloon times during left radial PCI in ACS patients.
Left subclavian angle <70° was associated with longer left radial PCI times; leaves open whether angle assessment should guide access choice in ACS.
Background and Aim: Patients with acute coronary syndrome who receive radial access by percutaneous coronary intervention (PCI) are less likely to experience clinical adverse events. The present study aimed to associate the PCI procedural time with left subclavian artery angle in acute coronary syndrome patients. Material and Methods: This retrospective study was carried out on 124 consecutive patients who underwent percutaneous coronary intervention in Punjab Institute of Cardiology, Lahore from June 2021 to June 2022. Prior to study conduction, the ethical committee approved the study protocol. After a CT scan on admission, patients with PCI via an LRA were included in this study. The angle of left subclavian artery was measured on CT scan through coronal view as an indicator for tortuosity and was related with procedural time and clinical variables. SPSS version 26 was used for data analysis. Results: Of the total 124 consecutive patients who underwent PCI, the left radial approach was used in 60 (48.4%) acute coronary syndrome patients. The overall mean age was 64.8±12.6 years. There were 37 (29.8%) females and 87 (70.2%) males. Severe tortuosity patients (left subclavian artery angle <70 degree) had higher incidence of female gender (41.6% vs. 14.2%, p<0.001), older age (73.8±9.87 vs. 59.6±14.2 years, P<0.005), higher subclavian artery calcification (72.6% vs. 32.8%, P=0.001), and hypertension (92.6% vs. 74.8%, P<0.01) than those with angle of left subclavian artery ≥70 degrees. Total procedural time (ρ=-0.29, P=0.003), and sheath cannulation to first balloon time (ρ=-0.48, P<0.001) were negatively associated with left subclavian artery angle. Conclusion: The present study found that Left subclavian artery lower angles are indicators of tortuosity via left radial approach significantly associated with total procedural time and sheath insertion long duration to the first balloon time during percutaneous coronary intervention.
No takes yet. Share an insight, caveat, or question.
Solangi et al. (2022) conducted an observational in Acute Coronary Syndrome (n=124). Left subclavian artery angle <70 degrees (severe tortuosity) vs. Left subclavian artery angle ≥70 degrees was evaluated on Total procedure time (minutes) (p=0.012). A left subclavian artery angle of <70 degrees was significantly associated with a longer total procedural time (80.4 vs 58.9 minutes) during left radial access percutaneous coronary intervention.
Synapse has enriched 5 closely related papers on similar clinical questions. Consider them for comparative context: