CARDIOVASCULAR JOURNAL OF AFRICA • PAFCIC 2021 Abstracts December 2021 59 AFRICA Submission ID: 1136 TEMPORAL TRENDS OF ALTERNATIVE ACCESS ROUTE AFTER TRANSRADIAL ACCESS FAILURE Fekih Romdhane Ahmed, Ghariani Anis, Ben Abdessalem Mohamed Aymen, Ben Ameur Zied, Ammar Fares, Saoudi Wassim, Mahdhaoui Abdallah, Jeridi Gouider UHC Farhat Hached, Tunisia Introduction Trans radial approach (TRA) for coronary catheterization is a worldwide fast growing technique. It has become the standard approach. However, one of its disadvantages is the high conversion rate to another approach. The aim of this study is to investigate alternative access site choice after TRA failure in our centre. Methods It was a retrospective study conducted in the cardiology department of Farhat Hached university hospital center. From February 2014 to May 2021, patients who underwent a catheterization procedure through a transradial approach were enrolled. The population was divided in two groups according to the admission period: first group from February 2014 to February 2015 and second group: from January 2020 to May 2021. In each group, the alternative coronary access route, after transradial access failure, was evaluated. Results A total of 895 patients underwent a coronary catheterization procedure through a transradial approach. The first group consisted of 336 patients and the second group consisted of 559 patients. Baseline characteristics were similar in both groups. Transradial access failure was reported in 10.2 % of the cases in the first group and in 11.2 % of the cases in the second group (p was not significant). After TRA access failure, TFA access was used in 66% in the first group against 26% in the second group (p<0.001). Contralateral or distal TRA was used in 32.1% in the first group against 54.6% in the second group (p<0.001). Transcubital access route was used only in the second group (18,2% vs 0%, p<0.001). Conclusion our work has shown that there is a regression in the use of the trans femoral approach as an alternative approach in the event of failure of the radial approach to the detriment of the contralateral radial approach and the cubital approach. MODERATED POSTER SESSION 4 Submission ID: 1142 THE “SMOKERS’ PARADOX”: DOES IT EXIST IN WOMEN? SKANDER BOUCHNAG, MEJDI BEN MESSAOUD, NIZAR IBN MECHRI, MAJED HASSINE, MOHAMED MEHDI BOUSSAADA, NIDHAL BOUCHAHDA, MARWEN MAHJOUB, FETHI BETBOUT, HABIB GAMRA CARDIOLOGY A DEPARTEMENT, FATTOUMA BOURGUIBA UNIVERSITY HOSPITALE , MONASTIR, TUNISIA Introduction The “smokers’ paradox” is a controversial phenomenon of an unexpectedly favorable outcome of smokers post-acute myocardial infarction (AMI). It has been well known and discussed in the male population, despite conflicting pieces of evidence from the literature so far. Aim The aim of this study is to investigate the existence of this phenomenon in the female population, particularly with the increase in the prevalence of smoking in this population. Patients and Method We have retrospectively inc1uded from the MIRAMI (MonastIR Acute Myocardial Infarction) register 324 women admitted for AMI in the Cardiology A department from January 1995 to December 2015. The population was divided into 2 groups: smokers and non-smokers. Submission ID: 1143 TO BE AN ANGLER THE FISH ROD DOESN’T MATTER NOAMEN Aymen, Raddaoui haythem, Tlili ghassen, Ben Ayed houssem, Hajlaoui nadhem, FEHRI Wafa Military hospital of Tunis, Tunisia Introduction: Coronary stent loss can be a very stressful experience for the operator. Fortunately, it is not a common complication in PCI, especially with the ever-improving equipment designs and the use of premounted stents. Herein we present the case of coronary stent loss, and its retrieval using a homemade snare. Case Presentation: We report the case of a 74-year-old female, with a long-standing history of hypertension and dyslipidemia, who presented with a NSTEMI in July of 2021. The angiography showed a severe stenosis of the distal left main coronary artery and a severe stenosis of the obtuse marginal artery for which she underwent a provisional T stenting of the left main and several attempt to cross the obtuse marginal lesion After two months, she remained symptomatic with severe exertional angina refractory to optimal medical treatment. She was referred to our department. Her angiography showed a permeable left main stent, and a subocclusion of the obtuse marginal artery, for which she underwent percutaneous coronary intervention. We opt to this approach. - 6F right radial -initial POT -opening of the struts in front of the side branch by a 2x10mm semi compliant balloon -kissing balloon -stenting of the obtuse marginal after predilatation. Upon completing the kissing balloon technique, we noticed a hazing in the ostium of the circumflex coronary artery (Cx). So, we decided to complete the TAP technique with kissing and final POT. However, we failed to deliver a 2.5x30mm stent Cx due to the despite balloon anchoring at the proximal left anterior descending artery. When trying to remove it, the stent was lost. Since there was no snare available in the cath lab, a homemade snare was used to successfully retrieve the stent. Conclusion: Since coronary stent loss may lead to serious outcomes that could even be fatal, operators should be familiar with stent retrieving techniques. It is always best to have the necessary toolbox to manage such a situation, but mastering a few craft techniques may sometimes prove very useful. Results Smoking was present in 13.3% (n = 43) with an average of 45.2 ± 27.8 pack-years. Female smokers were significantly younger (59.88 ± 12.65 years vs 66.89 ± 10.81 years, p <0.001), with less diabetes (25.6% vs 57.7%, p <0.001), less hypertension (27.9% vs 59.1, p <0.001), and less dyslipidemia (2.3% vs 14.2, p = 0.029). The anterior and inferior territories were predominant in both groups (p = 0.717). The rate of heart failure on admission was similar: 20.9% for the smokers and 25.6% for the non-smokers (p = 0.508). The use of myocardial reperfusion was greater in smokers (65.1% vs 49.8%, p=0.080), with an equal proportion of primary angioplasty and thrombolysis (27.9%). Rescue angioplasty was performed in 4 cases. In-hospital mortality was higher in non-smokers women, but this was not statistically significant (17.1% vs. Il.6%, p = 0.368). Conclusion According to our results, despite the absence of statistically significant difference, female smokers had a lower in-hospital mortality rate. Thus, the “smokers’ paradox” also seems to exist in our female population. Other larger studies need to be conducted to confirm this result.
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