EVALUATION OF STRUCTURAL CHANGES IN THE PULMONARY ARTERIES BY OPTICAL COHERENCE TOMOGRAPHY IN PATIENTS WITH PULMONARY ARTERIAL HYPERTENSION

day following the procedure. The primary outcome was a composite of: sheath insertion outside the common femoral artery limits, transfixing arterial puncture, 2 puncture attempts, hemoglobin drop 30 g/L or red blood cell transfusion, pseudo-aneurysm formation, retroperitoneal haemorrhage, arteriovenous fistula, arterial dissection, and thrombosis. Group comparisons were made using the chi-square test. A total of 80 patients, 73% male, aged 66 10 years, were randomized to the anatomical technique (n 1⁄4 40) or the ultrasound-guided technique (n 1⁄4 40). Indication for coronary angiography was stable angina in 30 (38%) patients and acute coronary syndrome in 50 (63%) patients. The primary composite outcome occurred in 34 (85%) patients randomized to the anatomical technique and in 23 (58%) patients randomized to the ultrasound-guided technique (p1⁄40.007). For every individual outcome, there was no difference in complication rates between anatomical and ultrasound-guided techniques, including specifically sheath insertion outside of the common femoral artery limits (18% vs 13%, respectively; p1⁄40.531). However, there was a trend towards more 2 puncture attempts (53% vs 35%; p1⁄40.115) with the anatomical technique. Significantly more venous punctures were made with the anatomical technique compared to the ultrasound-guided technique (68% vs 43% ; p1⁄40.045). When the sheath was not inserted in the common femoral artery, the most frequent sites of insertion were: superficial femoral artery (6 patients), external iliac artery (4 patients), and deep femoral artery (2 patients). CONCLUSION: In patients undergoing cardiac catheterization via the femoral artery, the ultrasound-guided technique is associated with less minor vascular complications and venous punctures. A trend towards less puncture attempts was also observed.