Radial artery access among mainstays of contemporary percutaneous coronary intervention: Is it time to forget how to puncture a femoral artery?

2019 ◽  
Vol 94 (3) ◽  
pp. 385-386
Author(s):  
Giuseppe Tarantini ◽  
Daniele Giacoppo
Keyword(s):  
Percutaneous Coronary Intervention ◽  
Radial Artery ◽  
Femoral Artery ◽  
Coronary Intervention ◽  
Percutaneous Coronary

P4597Impact of operator experience with radial approach for clinical outcome on percutaneous coronary intervention in acute coronary syndrome performed with femoral artery access site

2019 ◽  
Vol 40 (Supplement_1) ◽  
Author(s):  
T Tokarek ◽  
A Dziewierz ◽  
K Plens ◽  
T Rakowski ◽  
M Zabojszcz ◽  
...  
Keyword(s):  
Percutaneous Coronary Intervention ◽  
Acute Coronary Syndrome ◽  
Radial Artery ◽  
Femoral Artery ◽  
Coronary Intervention ◽  
Access Site ◽  
Radial Approach ◽  
Coronary Syndrome ◽  
Radial Access ◽  
Percutaneous Coronary

Abstract Introduction Radial approach (RA) for percutaneous coronary intervention (PCI) is associated with reduced mortality and access site complications. The routine use of the RA in patients should be strongly considered, keeping in mind the learning curve associated with the technique. However, promotion of RA may interfere with the equally important goal of maintaining proficiency in the femoral approach (FA), which is essential in a variety of procedures as well as when RA fails. There is possible risk of higher rate of complications in PCI with FA performed by operators mainly using radial artery as access site. Purpose The aim of this study was to evaluate impact of experience and proficiency with RA for clinical outcomes on PCI via FA in “real-world” patients with acute coronary syndrome (ACS). Methods A total of 539 invasive cardiologists performing PCI in 151 invasive cardiology centers on the Polish territory between 2014 and 2017 were included in study analysis. Proficiency threshold has been set at >400 procedures during four consecutive years per individual operator. They were categorized to quartiles according to total volume of radial artery utilization during all PCIs. Procedures performed on patients with Killip-Kimball class IV on admission to catheterisation laboratory were excluded from analysis. Results The most of the operators performed >75% of all procedures via radial artery (326 (60.5%)), 112 (20.8%) used RA in 50–75% of cases, 67 (12.4%) in 25–50% of all PCIs and only 34 (6.3%) invasive cardiologist were using RA in less than 25% of all procedures. Mortality during PCI via FA was higher in group of invasive cardiologist with >75% of all procedures performed with radial access (>75% vs. 50–75% vs. 25–50% vs. <25%: 1.63% (±2.52%) vs. 0.93% (±1.05%) vs. 0.68% (±0.73%) vs. 0.31% (±0.40%); p=0.01). A trend towards higher rate of bleeding at the puncture site during PCI procedures with femoral artery were reported in groups of operators with higher expertise in RA (>75% vs. 50–75% vs. 25–50% vs. <25%: 0.43% (±1.09%) vs. 0.14% (±0.36%) vs. 0.21% (±0.45%) vs. 0.14% (±0.37%); p=0.09). Conclusions Higher experience in radial access might be linked to worse outcome in PCI via FA in ACS settings. Femoral artery is important vascular approach and should not be abandoned while learning procedures with radial artery utilization. Acknowledgement/Funding None

scholarly journals Anxiety score as a predictor of radial artery spasm during transradial approach for percutaneous coronary intervention

2018 ◽  
Vol 70 ◽  
pp. S71
Author(s):  
Krishnarpan Chatterjee ◽  
Naveen Garg ◽  
Umamaheshwar K. L ◽  
Roopali Khanna ◽  
Aditya Kapoor ◽  
...  
Keyword(s):  
Percutaneous Coronary Intervention ◽  
Radial Artery ◽  
Coronary Intervention ◽  
Anxiety Score ◽  
Transradial Approach ◽  
Percutaneous Coronary

scholarly journals Radial artery access for coronary angiography and percutaneous coronary intervention

BMJ ◽  
2004 ◽  
Vol 329 (7463) ◽  
pp. 443-446 ◽  
Author(s):  
R Andrew Archbold ◽  
Nicholas M Robinson ◽  
Richard J Schilling
Keyword(s):  
Percutaneous Coronary Intervention ◽  
Coronary Angiography ◽  
Radial Artery ◽  
Coronary Intervention ◽  
Percutaneous Coronary

Haematoma after Coronary Angiography and Percutaneous Coronary Intervention via the Femoral Artery Frequency and Risk Factors

2005 ◽  
Vol 4 (2) ◽  
pp. 123-127 ◽  
Author(s):  
Kirsten Andersen ◽  
Marianne Bregendahl ◽  
Helen Kaestel ◽  
Mette Skriver ◽  
Jan Ravkilde
Keyword(s):  
Percutaneous Coronary Intervention ◽  
Coronary Angiography ◽  
Femoral Artery ◽  
Multivariate Logistic Regression Analysis ◽  
Coronary Intervention ◽  
Low Molecular Weight ◽  
Multivariate Logistic Regression ◽  
Increased Risk ◽  
Percutaneous Coronary ◽  
Made In

Background: The most common complication after coronary angiography (CA) and percutaneous coronary intervention (PCI) is the development of haematoma. Several changes in procedures regarding CA and PCI have been made in our department in recent years. The aim of this audit is to establish how many patients develop haematoma after CA/PCI via the femoral artery and subsequently to find predictors that increase the risk of developing haematoma. Methods: We initially included 474 consecutive patients-322 patients undergoing CA and 141 patients undergoing PCI. Eleven patients were later excluded due to the absence of complete data. Thirty-three variables were registered in order to find predictors, which might increase the haematoma frequency. A univariate as well as a multivariate logistic regression analysis was performed. Results: Of the 463 patients, 6 patients developed a haematoma > 10 cm (1.3%) and 41 patients developed a haematoma > 5 cm (8.9%). The following factors were found to be associated with the generation of haematoma: Women, systolic blood pressure > 160 mm Hg, artery puncture > 1, sheath time > 16 min, ACT ≥ 175 s, Glycoprotein (GP) IIB/IIIa inhibitors, Low Molecular Weight Heparin before procedure, personnel change during compression, and anti-coagulant-treatment before procedure. Conclusions: The frequency of haematoma was 1.3% (> 10 cm) and 8.9% (> 5 cm), which corresponds with reports from similar studies and departments. The factors found to increase the risk of haematoma development can provide background for procedural changes and increase the focus on patients at increased risk in order to minimize the development of haematomas.

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