SUCCESSIVE TRANSRADIAL APPROACH IS ASSOCIATED WITH AN ACCEPTABLE SUCCESS RATE AND A LOWER RISK OF VASCULAR COMPLICATIONS COMPARED TO THE TRANSFEMORAL APPROACH IN PATIENTS UNDERGOING REPEAT PERCUTANEOUS CORONARY INTERVENTION

2014 ◽  
Vol 30 (10) ◽  
pp. S92-S93
Author(s):  
P. Dehghani ◽  
E. Rezaei ◽  
A. Bagai ◽  
S. Al Nasser ◽  
H. Al Lawati ◽  
...  
Keyword(s):  
Percutaneous Coronary Intervention ◽  
Success Rate ◽  
Lower Risk ◽  
Vascular Complications ◽  
Coronary Intervention ◽  
Transfemoral Approach ◽  
Transradial Approach ◽  
Percutaneous Coronary

scholarly journals Comparison of In-Hospital Outcomes of ST Elevation Myocardial Infarction in Patients Undergoing Transradial and Transfemoral Primary Percutaneous Coronary Intervention

2019 ◽  
Vol 11 (2) ◽  
pp. 98-104
Author(s):  
Fahdia Afroz ◽  
Mir Jamal Uddin ◽  
Md Khalquzzaman ◽  
Mohammad Ullah ◽  
Mohammad Khalilur Rahman Siddiqui ◽  
...  
Keyword(s):  
Myocardial Infarction ◽  
Vascular Complications ◽  
Coronary Intervention ◽  
Adverse Outcomes ◽  
Transfemoral Approach ◽  
Transradial Approach ◽  
Group I ◽  
Percutaneous Coronary ◽  
St Elevation ◽  
Group Ii

Background: Primary percutaneous coronary intervention (PPCI) has been performed traditionally by using femoral approach. Transradial approach has become increasingly popular as it is likely to be less complicating, more comfortable and relatively cost effective having mortality and morbidity benefits. The aim of the study was to compare the in-hospital outcomes of transradial PPCI with that of transfemoral route. Methods: A total of 80 patients with ST elevation myocardial infarction (STEMI) who underwent PPCI were enrolled in the study. Patients were divided in two groups. Group-I: transradial PPCI; and Group-II: transfemoral PPCI. All patients were followed up during the period of hospital stay and adverse outcomes were observed and compared between the groups. Results: The result showed that bleeding took place in 2.5% patient of Group-I and 15% patients of Group- II. Vascular complications occurred in 2.5% and 12.5% patients of Group-I and Group-II, respectively. In Group-II, 7.5% patients died with none in Group-I. In Group-II, 37.5% patients experienced some sort of adverse outcomes whereas only 15% of the patients of Group-I did have such experiences (p<0.05). Bleeding and vascular complications were significantly more in Group-II (p<0.05). The mean hospital stay time was significantly lower in Group-I (p<0.001). Conclusions: Transradial PPCI is safer than transfemoral approach in respect of procedural and post procedural complications including bleeding, vascular complications and mortality. So, transradial approach may be an attractive alternative to conventional transfemoral approach and can be practiced routinely for PPCI. Cardiovasc. j. 2019; 11(2): 98-104

scholarly journals Association between body mass index and outcomes after percutaneous coronary intervention in multiethnic South East Asian population: a retrospective analysis of the Malaysian National Cardiovascular Disease Database—Percutaneous Coronary Intervention (NCVD-PCI) registry

BMJ Open ◽  
2017 ◽  
Vol 7 (11) ◽  
pp. e017794 ◽  
Author(s):  
Zaid Azhari ◽  
Muhammad Dzafir Ismail ◽  
Ahmad Syadi Mahmood Zuhdi ◽  
Norashikin Md Sari ◽  
Imran Zainal Abidin ◽  
...  
Keyword(s):  
Percutaneous Coronary Intervention ◽  
Lower Risk ◽  
East Asian ◽  
Vascular Complications ◽  
Asian Population ◽  
Coronary Intervention ◽  
Hospital Death ◽  
Percutaneous Coronary ◽  
Overweight Group ◽  
National Cardiovascular

ObjectiveTo examine the relationship between body mass index (BMI) and outcomes after percutaneous coronary intervention (PCI) in a multiethnic South East Asian population.SettingFifteen participating cardiology centres contributed to the Malaysian National Cardiovascular Disease Database—Percutaneous Coronary Intervention (NCVD-PCI) registry.Participants28 742 patients from the NCVD-PCI registry who had their first PCI between January 2007 and December 2014 were included. Those without their BMI recorded or BMI <11 kg/m2or >70 kg/m2were excluded.Main outcome measuresIn-hospital death, major adverse cardiovascular events (MACEs), vascular complications between different BMI groups were examined. Multivariable-adjusted HRs for 1-year mortality after PCI among the BMI groups were also calculated.ResultsThe patients were divided into four groups; underweight (BMI <18.5 kg/m2), normal BMI (BMI 18.5 to <23 kg/m2), overweight (BMI 23 to <27.5 kg/m2) and obese (BMI ≥27.5 kg/m2). Comparison of their baseline characteristics showed that the obese group was younger, had lower prevalence of smoking but higher prevalence of diabetes, hypertension and dyslipidemia. There was no difference found in terms of in-hospital death, MACE and vascular complications after PCI. Multivariable Cox proportional hazard regression analysis showed that compared with normal BMI group the underweight group had a non-significant difference (HR 1.02, p=0.952), while the overweight group had significantly lower risk of 1-year mortality (HR 0.71, p=0.005). The obese group also showed lower HR but this was non-significant (HR 0.78, p=0.056).ConclusionsUsing Asian-specific BMI cut-off points, the overweight group in our study population was independently associated with lower risk of 1-year mortality after PCI compared with the normal BMI group.

scholarly journals Central Vascular Complications Following Elective Catheterization Using Transradial Percutaneous Coronary Intervention

2017 ◽  
Vol 5 (1) ◽  
pp. 232470961769871 ◽  
Author(s):  
Julia Merkle ◽  
Christopher Hohmann ◽  
Anton Sabashnikov ◽  
Thorsten Wahlers ◽  
Jens Wippermann
Keyword(s):  
Percutaneous Coronary Intervention ◽  
Vascular Complications ◽  
Coronary Intervention ◽  
Artery Dissection ◽  
Case Presentation ◽  
Transradial Approach ◽  
Percutaneous Coronary ◽  
Artery Disease ◽  
The Right ◽  
Transradial Catheterization

Percutaneous coronary intervention is commonly used to treat coronary artery disease. Both transradial and transfemoral approaches are applied. In general, fewer complications are seen with the transradial approach compared to the transfemoral access, for which reason the transradial catheterization is frequently preferred. In this case presentation, we describe 2 cases of elective transradial coronary angiography both resulting in severe central vascular complications: perforation of the right subclavian artery with a mediastinal hematoma and dissection of the brachio-cephalic trunk and the aortic arch. Although the transradial access is generally considered safe, severe complications such as artery dissection or perforation can occur even in cases of elective procedures.

scholarly journals Comparison of Vascular Complications in Patients with Percutaneous Coronary Intervention by Trans-radial and Trans-femoral Approach

2019 ◽  
Vol 34 (2) ◽  
pp. 86-91
Author(s):  
ABM Riaz Kawsar ◽  
Mir Jamal Uddin ◽  
Abdul Momen ◽  
Tariq Ahmed Chowdhury ◽  
Kajal Kumar Karmoker ◽  
...  
Keyword(s):  
Percutaneous Coronary Intervention ◽  
Vascular Complications ◽  
Coronary Intervention ◽  
Patient Comfort ◽  
Transfemoral Approach ◽  
Radial Approach ◽  
Coronary Syndrome ◽  
Group I ◽  
Percutaneous Coronary ◽  
The Mean

Background and Objective: Trans-radial approach of coronary catheterization has been increasingly used as an alternative to transfemoral approach due to less vascular complications, earlier ambulation and improved patient comfort. The aim of the study was to compare procedural and post procedural vascular complications in patients with percutaneous coronary intervention by trans-radial and transfemoral approach. Methods: This observational comparative study was conducted in the National Institute of Cardiovascular Diseases between June 2015 to May 2016. A total of 180 patients were categorized into two groups according to the approach of the percutaneous coronary intervention (PCI). Group I comprising 90 patients who underwent trans-radial PCI and group II consists of 90 patients who underwent transfemoral PCI. Patients with an abnormal Allen’s test, acute coronary syndrome, history of coronary artery bypass surgery, chronic renal insufficiency or older age (>75 years) were excluded. Results: Patient demographics were the same in both groups. The mean procedural time in min (37.44±5.13 vs 34.14±4.42, p=0.004) and fluoroscopy time in min (21.62±4.11 vs 17.55±2.78, p=0.02) were more in TR-PCI group but the mean haemostasis time in min (7.58±1.11 vs 15.59±3.33, p=0.005) and ambulation time in hour (0.00±0.00 vs 15.59±3.33, p=<0.001) were more in TF-PCI group. Significant arterial spasm following puncture (6.7% vs 0%, p=0.01) were found in trans-radial group but access site bleeding during procedure (2.2% vs 8.9%, p=0.04) were more in TF-PCI group. After the procedure major hematoma (0% vs 4.4%, p=0.04), minor hematoma (5.7% vs 14.4%, p=0.04) and ecchymosis (4.4% vs 13.3%) were significant in TF-PCI group but vessel occlusion (5.7% vs 0%, p=0.02) were significant in TR-PCI group. The mean hospital stays, day (1.64±0.42 vs 2.54±0.62) were more in TF-PCI group. Conclusion: TR-PCI is safe in respect of procedural and post procedural vascular complications. Trans-radial procedure leads to improved quality of life after the procedure and thus gives much comfort to the patient. It also shortened mean duration of hospital stay. So, trans-radial approach is an attractive alternative to conventional transfemoral approach. Bangladesh Heart Journal 2019; 34(2) : 86-91

scholarly journals Robotic-Assisted Percutaneous Coronary Intervention Through Transradial Approach: Experience in 4 Patients with Complex Lesions

2020 ◽  
Vol 47 (2) ◽  
pp. 144-148
Author(s):  
Amornpol Anuwatworn ◽  
Muhammad Ali Kahn ◽  
Tomasz Stys ◽  
Marian Petrasko ◽  
Adam Stys
Keyword(s):  
Percutaneous Coronary Intervention ◽  
Coronary Artery ◽  
Coronary Intervention ◽  
Transfemoral Approach ◽  
Transradial Approach ◽  
Robotic Assisted ◽  
Diagonal Branch ◽  
Percutaneous Coronary ◽  
The Right ◽  
Complex Lesions

Robotic-assisted percutaneous coronary intervention can reduce the exposure of interventional cardiologists to radiation and minimize the risk of occupational orthopedic injuries from wearing heavy protective aprons. The PRECISE (Percutaneous Robotically-Enhanced Coronary Intervention) study showed the efficacy and safety of robotic-assisted procedures for relatively low-risk lesions in single coronary arteries. Several reports have described robotic-assisted treatment of complex high-risk lesions, mostly through the transfemoral approach. We report 4 cases of patients in whom we used the transradial approach to treat complex lesions in the left anterior descending coronary artery with bifurcation balloon angioplasty reconstruction (2 cases), in the ostium of the first diagonal branch, and in the right coronary artery.

Abstract P281: Impact of Transradial Approach on Quality of Care for Percutaneous Coronary Intervention: A Single Center Experience

2011 ◽  
Vol 4 (suppl_1) ◽  
Author(s):  
Chuntao Wu ◽  
Duanping Liao ◽  
Anne-Marie Dyer ◽  
Helen Chen ◽  
Ian C Gilchrist
Keyword(s):  
Quality Of Care ◽  
Lower Risk ◽  
Vascular Complications ◽  
Coronary Intervention ◽  
Adverse Outcomes ◽  
Transfemoral Approach ◽  
Transradial Approach ◽  
Risk Of Bleeding ◽  
The Difference

Background: Transradial cardiac catheterization has only been used in a small fraction of percutaneous coronary intervention (PCI) procedures in the United States, despite of the evidence that it may be associated with a lower risk of bleeding and mortality following PCI compared to the transfemoral approach. Objective: To evaluate the impact of the transradial approach on adverse outcomes following PCI and its potential of being a process to improve the quality of care for PCI in a single-center practice. Methods: We compared the risks of post-procedural adverse outcomes including in-hospital mortality, bleeding, and vascular complications between the 462 transradial and the 625 transfemoral cases who had undergone PCI procedures between January 2007 and March 2009. The difference in length of stay following PCI between the two entry approaches was also examined. Results: Compared to the transfemoral approach, the transradial cardiac catheterization was associated with significantly lower risk of bleeding (2.60% (12 of 462) vs. 6.08% (38 of 625); adjusted odds ratio (aOR)=0.34, 95% confidence interval (CI): 0.17-0.68, P=0.002) and vascular complications (0% vs. 1.44% (9 of 625), P=0.01). Although the trend was that the transradial approach was associated with lower risk of in-hospital mortality, the difference was not statistically significant (0.87% (4 of 462) vs. 2.24% (14 of 625); aOR=0.55, 95% CI: 0.14-2.10, P=0.38). Transradial patients were more likely to be discharged on the same day of procedure (14.2% vs. 2.2%, P<0.0001). Conclusion: The transradial approach is related to lower risk of bleeding and vascular complications. Introducing this approach to practice could improve the quality of care for PCI.

scholarly journals Transradial Approach in Primary Percutaneous Coronary Intervention: Lessons from a High-volume Centre

2016 ◽  
Vol 11 (2) ◽  
pp. 88 ◽  
Author(s):  
Lieuwe H Piers ◽  
Maarten A Vink ◽  
Giovanni Amoroso ◽  
◽  
◽  
...  
Keyword(s):  
Percutaneous Coronary Intervention ◽  
Large Body ◽  
High Volume ◽  
Coronary Intervention ◽  
Clinical Results ◽  
Transfemoral Approach ◽  
Transradial Approach ◽  
Coronary Syndrome ◽  
Percutaneous Coronary ◽  
European Society Of Cardiology

The transradial approach (TRA) is the recommended technique for percutaneous coronary intervention (PCI) in acute coronary syndrome, according to the European Society of Cardiology guidelines. There is a large body of evidence showing reduction in bleeding and mortality when the TRA is used. The TRA is also more convenient for patients, by allowing early mobilisation. Finally, by facilitating patient turnover and fast (re)transfer after the procedure, the TRA enables operators to meet the current recommendations of early invasive therapy in both ST and non-ST-elevation myocardial infarction. On the other hand, the TRA is technically more challenging than the transfemoral approach (TFA) and requires longer learning curve, which hinders its uptake by low-volume operators/centres. Nevertheless, in the hands of experienced high-volume operators, such as at Onze Lieve Vrouwe Gasthuis (OLVG) Amsterdam, the TRA achieves comparable procedural outcomes and favourable clinical results compared with the TFA, as it is in cases of primary PCI.

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