Acute Coronary Syndrome Clinical Trial
Official title:
Randomized Trial Between the Transfemoral Approach With AngioSeal and the Transradial Approach to Prevent Vascular Access Complications in Non-ST-Segment Elevation Acute Coronary Syndrome Patients Submitted To Early Invasive Strategy
Among non-ST-segment elevation acute coronary syndrome patients submitted to early invasive strategy and randomized for the transfemoral or transradial approach, the AngioSeal vascular closure device would decrease the prevalence of vascular complications at puncture site, reaching the non-inferiority criterion when compared to the radial access.
Antithrombotic therapy and percutaneous or surgical myocardial revascularization procedures
are the basis of the treatment of patients admitted with non-ST-segment elevation acute
coronary syndrome. However, the desired reduction of the recurrence of ischemic events has as
complication an increased incidence of bleeding. Since arterial puncture followed by the
insertion of an introducer has become the standard method to perform invasive cardiovascular
procedures, complications related to vascular access have become an important bleeding site.
Among the strategies to decrease vascular complications, the transradial approach is a well
stablished alternative to the transfemoral approach. For its part, vascular closure devices
were introduced to decrease vascular complications, homeostasis time and ambulation time of
patients submitted to invasive procedures by the transfemoral access. Rapidly incorporated to
the clinical practice, such devices to date have shown conflicting results with regard to
their safety and efficacy. The inconsistency of data proving its safety limits its routine
adoption as strategy to prevent vascular complications, requiring evidences through
adequately designed randomized studies for this end.
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