Original title: FFR in the Transradial Era: Will Hand Vein Adenosine Infusion Suffice?A Comparative Study of the Extent, Rapidity, and Stability of Hyperemia From Hand and Femoral Venous Routes of Adenosine Administration. Reference: Peter Scott et al. J Am Coll Cardiol Intv. 2015, online before print.
The aim of this study was to compare the administration of adenosine by a path in the back of the hand versus the same drug administration using a central venous access and observe differences to reach peak hyperemia during measurement of fractional flow reserve (FFR). Adenosine is commonly used to achieve maximum hyperemia during the measurement of FFR and the gold standard is administered by a central venous access. With the proliferation of radial access is desirable to have an alternative route around, however, it is unclear whether it is possible to achieve maximum hyperemia using a peripheral access.
Patients scheduled for FFR measurement were selected and administered adenosine sequentially through a 20G cannula into the back of the hand and after a washout of the drug, adenosine was re-administered through an inserter 5 or 6 Fr in the femoral vein. Adenosine was given at 140 ug / kg / min for each access. The interpretation of the data was blind regarding the administration via. Measurements were performed in 84 vessels of 61 patients with a mean value of FFR of 0.85 (0.986 correlation between both accesses). Hyperemia peak time was different, requiring an average of 22 seconds more for peripheral access (63 seconds versus 43 seconds; p <0.0001).
Conclusion
Adenosine infusion during FFR measurement by peripheral access is similar to the administration thereof by central access. This is important from a practical point of view for performing radial access procedures.
Editorial comment
In the FAME study, according to protocol, 140 ug / kg / min of adenosine by femoral venous access were administered and although in daily practice this same dose was often administered peripherally, there was so far, no evidence that it was equivalent. This is an interesting technical detail which increases the comfort of patients receiving radial access in the procedure.
SOLACI