Differences in symptoms during and post PTCA versus rotational ablation.

Abstract

Percutaneous transluminal coronary rotational ablation (PTCRA) has emerged as an effective therapy for the treatment of coronary artery disease. However, nursing management of these patients may differ from standard practices designed to care for coronary balloon angioplasty (PTCA) patients. To examine factors that could impact nursing care we compared 233 patients undergoing PTRCA with 301 patients undergoing PTCA. Overall, clinical success did not differ between the groups. Patients undergoing PTCRA were more likely to experience hypotension and prolonged angina in the cardiac catherization laboratory than patients undergoing PTCA. PTCRA patients were also more likely to require i.v. heparin and i.v. nitroglycerin post procedure than PTCA patients. In addition, PTCRA patients were on i.v. nitroglycerin for longer periods of time post procedure than PTCA patients. There were no differences between the groups in the occurrence of peripheral bleeding, hematoma, or length of hospital stay. In summary, PTRCA patients have more hypotension and angina during rotational ablation procedures, and are more likely to require heparin and nitroglycerin post procedure. These differences require nursing strategies which incorporate closer monitoring of patients and patients' symptoms, along with educating patients about the need for longer i.v. drug therapy.