Patient comfort in percutaneous coronary interventions

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Abstract

Objectives:

To identify patients’ general comfort levels in percutaneous coronary intervention.

Methods:

This descriptive research included 2 hundred cardiac patients, whom were in the Medipol Mega University Hospital, Istanbul, during the period between May 2018 and May 2019. The data were obtained by General Comfort Questionnaire and evaluated using mean, standard deviation, percentage and t-test.

Results:

In this study reports that patients had the mean total comfort score as 3.03±0.3. They acquired the maximum score from the psychospiritual comfort subdimension and the minimum score from the physical comfort subdimension. Patients who experienced transradial percutaneous coronaryintervention had statistically higher general, physical, psycospiritual and environmental comfort levels than those who had transfemoral intervention ( p<0.05). According to both access methods, relief and ease levels were significantly different.

Conclusion:

Patients who experienced percutaneous coronary intervention have above medium general comfort levels. Their physical comfort scored lowest within the comfort dimensions investigated in this study. The comfort level of the patients to whom the transradial method was applied was found to be higher in comparison with the transfemoral method.

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Most cited references 35

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Radial Versus Femoral Access for Coronary Interventions Across the Entire Spectrum of Patients With Coronary Artery Disease: A Meta-Analysis of Randomized Trials.

Giuseppe Ferrante, Sunil V Rao, Peter Jüni … (2016)

The aim of this study was to provide a quantitative appraisal of the effects on clinical outcomes of radial access for coronary interventions in patients with coronary artery disease (CAD).

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Transradial cardiac catheterization: a review of access site complications.

Yili Huang, Navin C Nakra, Michael Liou … (2011)

Transradial catheterization (TRC) has been associated with a lower incidence of major access site related complications as compared to the transfemoral approach. With the increased adoption of transradial access, it is essential to understand the potential major and minor complications of TRC. The most common complication is asymptomatic radial artery occlusion, which rarely leads to clinical events, owing to the dual collateral perfusion of the hand. Adequate anticoagulation, appropriate compression techniques, and smaller sheath size can minimize the risk of radial artery occlusion. Hand ischemia with necrosis has never been reported during TRC with thorough pre-examination of intact collateral circulation. Radial artery spasm is relatively common, and can result in access and procedural failure. It can be prevented by the use of vasodilator cocktails and hydrophilic sheaths. Radial artery perforation can lead to severe forearm hematoma and compartment syndrome if not managed promptly. Careful observation, prompt detection of the hematoma, and management with a pressure bandage dressing are critical to avoid serious complications. Pseudoaneurym and arteriovenous fistula are rare complications, which can likely be managed conservatively without surgical intervention. Nerve injury occurring during access has been reported. Close observation for improvement is necessary, although symptoms usually improve over time. In summary, to prevent access site complications, avoidance of multiple punctures, gentle catheter manipulation, use of guided compression, coupled with careful observation for adverse warning signs such as hematoma, loss of pulse, pain, are critical for safe and effective TRC. Copyright © 2011 Wiley Periodicals, Inc.

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Coronary angiography through the radial or the femoral approach: The CARAFE study.

Y Louvard, A Allain, Christopher Lefèvre … (2001)

In a previous study, the radial approach for coronary angiography was shown to be associated with a lower success rate and longer procedural and X-ray times compared to the femoral approach. However, this approach is associated with a steep learning curve. A series of 210 consecutive nonselected patients were randomized to femoral versus right radial approach or femoral versus left radial approach by two experienced operators. Clinical characteristics were similar in the three groups. Technical failure occurred in one patient in the right radial group with subsequent crossover to left radial artery. The number of coronary catheters used was lower in the right radial group (1.4 +/- 0.7 vs. 2.1 +/- 0.4 for the two other groups). The procedural duration was longer with left radial (14.2 +/- 3.3 min; P < 0.05) approach than with right radial (12.4 +/- 5.8 min) and femoral (11.2 +/- 3.3 min) without significant differences between femoral and right radial. X-ray exposure was shorter in the femoral group (3.1 +/- 1.7 min) than in both radial groups (right: 3.8 +/- 2.2 min; left: 4.2 +/- 1.7 min). The angiographic quality was not different between the three groups for RCA, but was less good for LCA through right radial approach. Bed rest and hospital stay were shorter in the two radial groups. The comfort was judged better with the transradial approach. An ad hoc PTCA was performed in 45.7% of femoral patients, 41.4% of right radial, and 44.3% of left radial with immediate sheath withdrawal (closure device for femoral group). There were no severe complications in the three groups, but two patients from the femoral group were discharged later because of vascular complications. The total cost of coronary angiography was higher in the femoral group. In conclusion, after the learning period, transradial coronary angiography can be performed with a high success rate, low rate of complication, and good angiographic quality. It is associated with a slight increase in procedural (LR) and fluoroscopy times, but permits earlier ambulation and discharge, improves patient comfort, and reduces the cost.

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Author and article information

Journal

Journal ID (nlm-ta): Saudi Med J

Journal ID (iso-abbrev): Saudi Med J

Journal ID (hwp): smj

Journal ID (publisher-id): SAMJDI

Title: Saudi Medical Journal

Publisher: Saudi Medical Journal

ISSN (Print): 0379-5284

ISSN (Electronic): 1658-3175

Publication date (Print): May 2023

Volume: 44

Issue: 5

Pages: 471-478

Affiliations

From the Coronary Angiography Unit (Çıracı), Memorial Bahçelievler Hospital; and from Department of Surgical Nursing (Rızalar), University of Health Science, Hamidiye Nursing Faculty, Istanbul, Turkey.

Author notes

Address correspondence and reprint request to: Dr. Selda Rızalar, Department of Surgical Nursing, University of Health Science, Hamidiye Nursing Faculty, Istanbul, Turkey. E-mail: selda.rizalar@ 123456sbu.edu.tr ORCID ID: https://orcid.org/0000-0002-1592-9926

Article

Publisher ID: SaudiMedJ-44-5-471

DOI: 10.15537/smj.2023.44.5.20220872

PMC ID: 10187743

PubMed ID: 37182915

SO-VID: 55584160-b455-417e-9b1c-710835e74f6f

License:

This is an Open Access journal and articles published are distributed under the terms of the Creative Commons Attribution-NonCommercial License (CC BY-NC). Readers may copy, distribute, and display the work for non-commercial purposes with the proper citation of the original work.

History

Date received : 18 January 2023

Date accepted : 9 April 2023

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Patient comfort in percutaneous coronary interventions

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Abstract

Objectives:

Methods:

Results:

Conclusion:

Related collections

The Physician

Most cited references 35

Radial Versus Femoral Access for Coronary Interventions Across the Entire Spectrum of Patients With Coronary Artery Disease: A Meta-Analysis of Randomized Trials.

Transradial cardiac catheterization: a review of access site complications.

Coronary angiography through the radial or the femoral approach: The CARAFE study.

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Cited by 1