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Radial vs. femoral approach for primary percutaneous coronary intervention in octogenarians

Koutouzis, Michael ; Matejka, Göran ; Olivecrona, Göran LU ; Grip, Lars and Albertsson, Per LU (2010) In Cardiovascular Revascularization Medicine 11(2). p.79-83
Abstract

BACKGROUND: The transradial approach is associated with fewer bleeding complications during percutaneous coronary interventions (PCIs) but is more technically challenging and associated with prolonged times during intervention. The aim of this study is to retrospectively compare the results of radial vs. femoral approach in patients >or=80 years old undergoing primary or rescue PCI.METHODS: Between January 2002 and December 2007, 354 interventions were performed in our institution with the indication of primary or rescue PCI in patients over 80 years old, without history of previous bypass operation or cardiogenic shock on presentation. Thirteen patients required a change of the approach during the procedure and were not enrolled in... (More)

BACKGROUND: The transradial approach is associated with fewer bleeding complications during percutaneous coronary interventions (PCIs) but is more technically challenging and associated with prolonged times during intervention. The aim of this study is to retrospectively compare the results of radial vs. femoral approach in patients >or=80 years old undergoing primary or rescue PCI.METHODS: Between January 2002 and December 2007, 354 interventions were performed in our institution with the indication of primary or rescue PCI in patients over 80 years old, without history of previous bypass operation or cardiogenic shock on presentation. Thirteen patients required a change of the approach during the procedure and were not enrolled in the final analysis. Forty (12%) interventions were performed through the transradial approach and 301 (88%) through the femoral approach. In-hospital major adverse cerebral and cardiac events and access site bleeding complications as well as 30- and 365-day mortality, procedural times, and contrast volume were evaluated.

RESULTS: The two groups had similar clinical characteristics, with the exception of serum creatinine that was higher in the transfemoral approach group. There were no differences in procedural times and clinical outcomes, although the transfemoral group had numerically more access site bleeding complications (12/301 vs. 0/40, P=.41). The transradial approach had a higher conversion rate compared with the transfemoral approach (18.3% vs. 1.3%, P<.001).

CONCLUSION: The transradial approach is feasible and safe in the octogenarians undergoing primary and rescue PCI, but it is associated with a high conversion rate to another approach.

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organization
publishing date
type
Contribution to journal
publication status
published
subject
keywords
Age Factors, Aged, 80 and over, Angioplasty, Balloon, Coronary/adverse effects, Biomarkers/blood, Cerebrovascular Disorders/etiology, Coronary Angiography, Coronary Artery Disease/diagnostic imaging, Creatinine/blood, Feasibility Studies, Female, Femoral Artery, Hemorrhage/etiology, Hospital Mortality, Humans, Male, Radial Artery, Retrospective Studies, Risk Assessment, Risk Factors, Severity of Illness Index, Time Factors, Treatment Outcome
in
Cardiovascular Revascularization Medicine
volume
11
issue
2
pages
5 pages
publisher
Elsevier
external identifiers
  • pmid:20347796
  • scopus:77949892515
ISSN
1878-0938
DOI
10.1016/j.carrev.2009.04.107
language
English
LU publication?
yes
id
09d14696-0722-463f-8edf-3df3ceccb9de
date added to LUP
2021-02-02 11:13:28
date last changed
2024-01-03 05:50:39
@article{09d14696-0722-463f-8edf-3df3ceccb9de,
  abstract     = {{<p>BACKGROUND: The transradial approach is associated with fewer bleeding complications during percutaneous coronary interventions (PCIs) but is more technically challenging and associated with prolonged times during intervention. The aim of this study is to retrospectively compare the results of radial vs. femoral approach in patients &gt;or=80 years old undergoing primary or rescue PCI.METHODS: Between January 2002 and December 2007, 354 interventions were performed in our institution with the indication of primary or rescue PCI in patients over 80 years old, without history of previous bypass operation or cardiogenic shock on presentation. Thirteen patients required a change of the approach during the procedure and were not enrolled in the final analysis. Forty (12%) interventions were performed through the transradial approach and 301 (88%) through the femoral approach. In-hospital major adverse cerebral and cardiac events and access site bleeding complications as well as 30- and 365-day mortality, procedural times, and contrast volume were evaluated.</p><p/><p>RESULTS: The two groups had similar clinical characteristics, with the exception of serum creatinine that was higher in the transfemoral approach group. There were no differences in procedural times and clinical outcomes, although the transfemoral group had numerically more access site bleeding complications (12/301 vs. 0/40, P=.41). The transradial approach had a higher conversion rate compared with the transfemoral approach (18.3% vs. 1.3%, P&lt;.001).</p><p>CONCLUSION: The transradial approach is feasible and safe in the octogenarians undergoing primary and rescue PCI, but it is associated with a high conversion rate to another approach.</p>}},
  author       = {{Koutouzis, Michael and Matejka, Göran and Olivecrona, Göran and Grip, Lars and Albertsson, Per}},
  issn         = {{1878-0938}},
  keywords     = {{Age Factors; Aged, 80 and over; Angioplasty, Balloon, Coronary/adverse effects; Biomarkers/blood; Cerebrovascular Disorders/etiology; Coronary Angiography; Coronary Artery Disease/diagnostic imaging; Creatinine/blood; Feasibility Studies; Female; Femoral Artery; Hemorrhage/etiology; Hospital Mortality; Humans; Male; Radial Artery; Retrospective Studies; Risk Assessment; Risk Factors; Severity of Illness Index; Time Factors; Treatment Outcome}},
  language     = {{eng}},
  month        = {{03}},
  number       = {{2}},
  pages        = {{79--83}},
  publisher    = {{Elsevier}},
  series       = {{Cardiovascular Revascularization Medicine}},
  title        = {{Radial vs. femoral approach for primary percutaneous coronary intervention in octogenarians}},
  url          = {{http://dx.doi.org/10.1016/j.carrev.2009.04.107}},
  doi          = {{10.1016/j.carrev.2009.04.107}},
  volume       = {{11}},
  year         = {{2010}},
}