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Öğe Cutaneous analgesia before transradial access for coronary intervention to prevent radial artery spasm(Sage Publications Ltd, 2018) Tatli, Ersan; Yilmaztepe, Mustafa Adem; Vural, Mustafa Gokhan; Tokatli, Alptug; Aksoy, Murat; Agac, Mustafa Tarik; Cakar, Mehmet AkifAim: Transradial access (TRA) for coronary intervention is increasingly used in current clinical practice. The aim of the present study was to evaluate the hypothesis that cutaneous analgesia before TRA for coronary intervention at a puncture site 30 minutes before puncture can reduce patient discomfort and the incidence of radial artery spasm (RAS). Methods: Patients (n=104) undergoing planned coronary interventions using TRA were prospectively randomized to receive either 1 mL of 1% lidocaine subcutaneously (n=52) (control group) or subcutaneous lidocaine plus 5% lidocaine cream (n=52) cutaneously 30 minutes before puncture (treatment group). The primary endpoint was angiographically or clinically confirmed RAS. Secondary endpoints were the occurrence of patient discomfort in the forearm during the procedure and access-site crossover to the femoral artery. Patient discomfort was quantified with a visual analogue scale (VAS) score. Results: Fifty-two patients in the treatment group (60.5 +/- 9.4 years of age and 16 female) and 52 patients in the control group (60.4 +/- 9.7 years of age and 16 female) were included in the final analysis. Radial artery spasm occurrence decreased in the treatment group compared to the control group (26.9% vs 9.6%; p=0.04) accompanied by a VAS score of 3.7 +/- 1.8 in the treatment group and 4.9 +/- 2.0 in the control group; p=0.02. The access site crossover rate did not differ between the groups (7.6% vs 21.1%; p=0.09). Conclusion: Cutaneous analgesia before TRA for coronary interventions is associated with a substantial reduction in the RAS and the procedure-related level of patient discomfort.Öğe Survival of patients with well-developed collaterals undergoing CABG or medical treatment: An observational case-controlled study(Turkish Soc Cardiology, 2012) Tatli, Ersan; Aktoz, Meryem; Cakar, Mehmet Akif; Dogan, Emir; Alkan, Mustafa; Ozalp, BilhanObjective: The effects of coronary artery bypass grafting (CABG) on mortality have not been evaluated in patients with well-developed coronary collaterals. We investigated functional capacity, presence of angina, the occurrence of acute myocardial infarction, survival and mortality in patients with well-developed coronary collaterals both undergoing and refusing CABG. Methods: The study was designed as a retrospective observational case-controlled study. Seventy-eight patients undergoing coronary angiography were included in this study. They had critical occlusion in the proximal left anterior descending artery (LAD) with Rentrop-3 collateral circulation towards LAD, and to proceed with CABG has been suggested. The patients were divided in two groups; first group proceeding with CABG (n=40) and the second, rejecting the surgery (medical treatment group; n=38). The rates of survival, the incidence of angina pectoris and acute myocardial infarction as well as the functional capacities were evaluated in all patients. Survival rates were evaluated using Kaplan-Meier survival analysis. Results: No statistically significant difference was observed between the two groups regarding the baseline characteristics of patients, the presence of angina pectoris, the severity of angina pectoris according to CCS, the occurrence of acute myocardial infarction or stroke, and the functional capacity according to NYHA (p>0.05). Death due to cardiovascular reasons was observed in eight patients of CABG group and in five patients of medical treatment group (p=0.710). The 5-year survival rate was observed to be 80% in CABG group while it was observed to be 84% in the medical treatment group (p=0.730). Conclusion: There was no significant difference regarding the survival rates in patients with well-developed coronary collaterals proceeding with CABG or medical treatment. (Anadolu Kardiyol Derg 2012; 12: 97-101)