Biopsia endomiocárdica por vía venosa braquial.Descripción de la técnica y experiencia en 12 años de 2 centros

  1. María Tamargo 2
  2. Enrique Gutiérrez Ibañes 2
  3. Juan Francisco Oteo Domínguez 1
  4. Felipe Díez 2
  5. Ebrey León Aliz 1
  6. Ricardo Sanz Ruiz 2
  7. Francisco José Hernández Pérez 1
  8. María Eugenia Vázquez Alvarez 2
  9. Javier Segovia Cubero 1
  10. Allan Rivera Juárez 2
  11. Eduardo Zatarain 2
  12. Javier Goicolea Ruigómez 1
  13. Javier Soriano Triguero 2
  14. E. Pérez Pereira 1
  15. Jorge García Carreño 2
  16. Arturo García Touchard 1
  17. Lilian Grigorian Shamagian 2
  18. José Antonio Fernández Díaz 1
  19. Jaime Elízaga Corrales 2
  20. Luis Alonso Pulpón Rivera 1
  21. F. Fernández Avilés 2
  1. 1 Departamento de Cardiología, Hospital Universitario Puerta de Hierro, Majadahonda, Madrid, España
  2. 2 Departamento de Cardiología Hospital General Universitario Gregorio Marañón, Instituto de Investigación Sanitaria Gregorio Marañón, CIBERCV, Instituto de Salud Carlos III, Madrid, España
Revista:
REC: Interventional Cardiology

ISSN: 2604-7276 2604-7306

Ano de publicación: 2020

Volume: 2

Número: 4

Páxinas: 264-271

Tipo: Artigo

DOI: 10.24875/RECIC.M20000107 DIALNET GOOGLE SCHOLAR lock_openDialnet editor

Outras publicacións en: REC: Interventional Cardiology

Obxectivos de Desenvolvemento Sustentable

Resumo

ABSTRACT Introduction and objectives: Recipients of a heart transplant need to receive serial endomyocardial biopsies (EMB) to discard rejection, a procedure that is usually performed through the femoral or jugular vein. Over the last few years, we have developed a technique to perform EMBs using the brachial venous access that we have implemented as the preferential access route. In this article, we describe the technique and the initial clinical experience of 2 different centers. Methods: Between 2004 and 2016, we developed and implemented a brachial venous access technique. We registered the main clinical and procedural variables of all the brachial biopsies performed in both centers and compared them with a retrospective series of femoral and jugular procedures. Results: Brachial EMBs were successfully performed 544 of the time with no major complications. The number of brachial procedures per patient rose from 1 to 14. Over the same period of time 1054 femoral and 686 jugular procedures were performed. The total procedural time was similar with different access routes (mean for brachial/femoral/jugular access: 28/26/29 min., P = .31) while fluoroscopy time was shorter in jugular procedures (mean 5/5/3 min. respectively; P < .001). The brachial procedure was recalled as the least painful procedure of all compared to the jugular or femoral ones (2/8/9 score on a scale from 1 to 10; P = .001) with an overall patient preference towards the brachial access. Conclusions: The venous brachial access route is a good alternative to the central venous one to perform EMBs and is the route of choice in our centers. Also, it has high feasibility and safety and brings additional comfort to patients.

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