Randomized study comparing incidence of radial artery occlusion post-percutaneous coronary intervention between two conventional compression devices using a novel airinflation technique

AIM To compare post-percutaneous coronary intervention(PCI) radial artery occlusion(RAO) incidence between two conventional radial artery compression devices using a novel air-inflation technique.METHODS One hundred consecutive patients post-PCI were randomized 1:1 to Safeguard or TR band compression devices. Post-radial sheath removal, each compression device was inflated with additional 2 m L of air above index bleeding point during air-filled device application and gradually down-titrated accordingly. RAO was defined as absence of Doppler flow signal performed at 24 h and at 6 wk post-PCI. Patients with missing data were excluded. Statistical significance was defined as P < 0.05.RESULTS All patients had 6 F radial sheath inserted. No significant differences were observed between Safeguard Radial(n = 42) vs TR band(n = 42) in terms of age(63 ± 11 years vs 67 ± 11 years), clinical presentation(electives, n = 18 vs n = 16; acute coronary syndrome, n = 24 vs n = 26) and total procedural heparin(7778 ± 2704 IU vs 7825 ± 2450 IU). RAO incidence was not significantly different between groups at 24 h(2% vs 0%, P = 0.32) and 6 wk(0%, both).CONCLUSION Safeguard Radial and TR band did not demonstrate significant between-group differences in short-term RAO incidence. Lack of evidence of RAO in all postPCI patients at 6 wk follow-up, regardless of radial compression device indicate advantage of using the novel and pragmatic air-inflation technique. Further work is required to more accurately confirm these findings.

Multi-modality imaging in transthyretin amyloid cardiomyopathy

Transthyretin amyloid(TTR)cardiomyopathy is a disease of insidious onset,which is often accompanied by debilitating neurological and/or cardiac complications.The true prevalence is not fully known due to its elusive presentation,being often under-recognized and usually diagnosed only late in its natural history and in older patients.Because of this,effective treatment options are usually precluded by multiple comorbidities and frailty associated with such patients.Therefore,high clinical suspicion with earlier and better detection of this disease is needed.In this review,the novel applications of multimodality imaging in the diagnostic pathway of TTR cardiomyopathy are explored.These include the complimentary roles of transthoracic echocardiography,cardiac magnetic resonance,nuclear scintigraphy and positron emission tomography in quantifying cardiac dysfunction,diagnosis and risk stratification.Recent advances in novel therapeutic options for TTR have further enhanced the importance of a timely and accurate diagnosis of this disease.