Comparison of TR Band Protocols after Transradial Access PDF

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Heart, Lung and Circulation S125 2010;19S:S1–S268 Abstracts ABSTRACTS assessed as minimal vs. partial/heavy. Patients assessed >200 ␮mol/L, and were current smokers (all p ≤ 0.02). Over with CTA, MRA and DSA pre-procedure were assigned a 2.2 years of follow-up, mortality was similar between the r...

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assessed as minimal vs. partial/heavy. Patients assessed with CTA, MRA and DSA pre-procedure were assigned a risk score from 0 to 6 for each modality based on the number of predefined unfavourable anatomic characteristics. Results: DUS, CTA and MRA showed high rates of concordance with DSA (86%, 93%, 72% respectively) in assessing CSS. There was no significant difference between weighted-kappa scores (p = 0.56). Higher extents of lesion calcification were noted with CTA and MRA compared to DUS and DSA (p = 0.016). There was a significant difference between risk scores with non-invasive imaging modalities: DSA = 2.83 ± 1.15, CTA = 4.06 ± 1.16, MRA = 3.50 ± 0.89 (p = 0.005). Conclusions: All non-invasive imaging modalities have high concordance to DSA for evaluation of carotid stenosis severity. CTA may be preferred for anatomic risk assessment, as it is the most sensitive for detection of high-risk anatomic traits. doi:10.1016/j.hlc.2010.06.959 293 Comparison of Percutaneous Coronary Intervention and Coronary Artery Bypass Grafting for Revascularization of Patients with Diabetes Mellitus W. Chan 1,∗ , N. Andrianopoulos 2 , D. Clark 3 , A. Ajani 4 , A. Brennan 2 , A. Newcomb 5 , P. Naidu 1 , J. Smith 6 , M. Butler 1 , M. Freeman 3 , A. Dart 1 , D. Dinh 2 , S. Duffy 1 1 Alfred

Hospital, Australia of Epidemiology and Preventive Medicine (DEPM), Monash University, Australia 3 Austin Hospital, Australia 4 Royal Melbourne Hospital, Australia 5 St Vincent’s Hospital, Australia 6 Southern Health, Australia 2 Department

Background: Sub-group analyses of several randomised-controlled trials of percutaneous coronary intervention (PCI) versus coronary artery bypass grafting (CABG) suggest that diabetics with multivessel coronary artery disease (CAD) have improved event-free survival with CABG. Method: We compared clinical characteristics and longterm mortality using National Death Index data in 3455 patients with diabetes who underwent revascularization; either PCI (n = 1112; 32%) or CABG (n = 2343; 68%) in two large, parallel, multi-centre registries from April 2004 to October 2008. Cardiogenic shock, acute myocardial infarction (MI) 200 ␮mol/L, and were current smokers (all p ≤ 0.02). Over 2.2 years of follow-up, mortality was similar between the CABG and PCI cohorts (6.0% vs. 5.4%, p = 0.47). Significant multivariate predictors of mortality included age (HR 1.05 per year; 95% CI 1.03–1.06, p < 0.0001), creatinine (4.3; 2.9–6.4, p < 0.0001), IABP use (3.0; 1.7–5.3, p < 0.0001) and prior MI (1.5; 1.1–2.1, p = 0.01), but not the mode of revascularisation (0.99; 0.7–1.5, p = 0.94). Conclusion: In this multi-centre, real world registry of patients with diabetes requiring revascularization, CABG and PCI provide comparable long-term mortality benefit. doi:10.1016/j.hlc.2010.06.960 294 Comparison of TR Band Protocols after Transradial Access M. De Raya ∗ , Y. Goh, I. Shugman, C. Juergens, S. Lo Liverpool Hospital, Australia Objective: To evaluate two different protocols for TR band haemostatic device on radial artery haemostasis and complications after transradial catheterization. Background: Terumo® ’s TR BandTM has a protocol on weaning of pressure at certain time intervals. However, we encountered a larger than expected bleeding complication rates in our centre. Early oozing, hematoma and delayed haemostasis are frequent with the Terumo® ’s protocol. Hence, we proposed a new alternative protocol to decrease our complications rate. Methods: A total of 250 consecutive cases of patients undergoing transradial coronary catheterization and/or intervention from August 2006 to July 2009 were included. The original Terumo® protocol (Group 1) was applied on the earlier 55 cases and the new TR bandTM protocol (Group 2) was applied on the subsequent 195 cases. Complication rates and time-to-haemostasis were compared between the 2 groups. Results: There were 23 patients in Group 1 with oozing complication compared to 52 in Group 2 (41.8% vs. 26.7%, p = 0.030). There were 6 patients in Group 1 who developed haematoma, compared to 7 in Group 2 (10.9% vs. 3.6%, p = 0.031). The combined bleeding complication was 25 in Group 1 and 54 in Group 2 (45.5% vs. 27.7%, p = 0.012). However the total duration to haemostasis was longer in Group 2 as compared to Group 1 (155 ± 47 min vs. 129 ± 40 min, p < 0.01). Conclusion: A significant reduction in bleeding complications was noted with our new protocol as compared to Terumo® ’s original protocol. However, time-tohaemostasis is longer with the new protocol. doi:10.1016/j.hlc.2010.06.961

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Heart, Lung and Circulation 2010;19S:S1–S268...