Masaya Otsuka, Nobuo Shiode, Yasuhisa Nakao, Yuki Ikegami, Yusuke Kobayashi, Arinori Takeuchi, Ayako Harima, Tadanao Higaki, Kuniomi Oi, Kazuoki Dai, Tomoharu Kawase, Yasuharu Nakama, Kazuyoshi Suenari, Kenji Nishioka, Koyu Sakai, Yuji Shimatani, Yoshiko Masaoka, Ichiro Inoue
Some studies have suggested that radial access (RA) for percutaneous coronary intervention (PCI) reduces vascular complications and bleeding compared to femoral access (FA). The purpose of this study was to investigate the routine use of hemostatic devices and bleeding complications among RA, brachial access (BA), and FA. Between January 2015 and December 2015, 298 patients treated for PCI with RA were compared with 158 patients using BA and 206 patients using FA. The radial sheath was routinely removed with ADAPTY, the brachial sheath with BLEED SAFE, and the femoral sheath with Perclose ProGlide...
January 2018: Cardiovascular Intervention and Therapeutics
David R Dobies, Kimberly R Barber, Amanda L Cohoon
OBJECTIVE: Using a multisite, contemporary registry of 58 862 percutaneous coronary intervention (PCI) procedures in a national healthcare system, the present study compared radial access with femoral access on safety and efficacy outcomes. METHODS: This is a real-world, large-scale, retrospective study using clinical data from a 137-hopsital System and reported to a multisite clinical registry. All patients undergoing a cardiac catheterisation procedure were included in this database...
2016: Open Heart
Surya Dharma, Ian C Gilchrist, Tejas Patel
Radial artery access is preferred over femoral access for primary percutaneous coronary intervention (PCI) in patients with acute ST-segment elevation myocardial infarction because of the reduction in access site complications and mortality associated with the radial artery access. Successful transradial primary PCI requires knowledge of techniques to handle unexpected severe subclavian artery tortuosity. Balloon-assisted tracking (BAT) is one technique developed to negotiate the tortuosity and loops in the upper extremity...
June 2016: International Journal of Angiology: Official Publication of the International College of Angiology, Inc
Rachit M Shah, Dhavalkumar Patel, Antonio Abbate, Michael J Cowley, Ion S Jovin
INTRODUCTION: Coronary angiography and angioplasty via transradial approach is shown to be associated with significant reduction in access site complications. Due to a lack of sufficient data, the use of the right or left radial approach is still operator-dependent. We performed a meta-analysis of prospective randomized studies to compare right versus left radial artery approach for coronary procedures. METHODS: We found 12 randomized studies meeting the predetermined inclusion criteria...
December 2016: Catheterization and Cardiovascular Interventions
Eltigani Abdelaal, Jimmy MacHaalany, Guillaume Plourde, Alberto Barria Perez, Marie-Pier Bouchard, Melanie Roy, Jean-Pierre Déry, Ugo Déry, Gérald Barbeau, Éric Larose, Onil Gleeton, Bernard Noël, Josep Rodés-Cabau, Louis Roy, Olivier Costerousse, Olivier F Bertrand
OBJECTIVES: To determine predictors of failure of transradial approach (TRA) in patients with ST elevation myocardial infarction (STEMI) undergoing primary percutaneous coronary intervention (PCI), and develop a novel score specific for this population. METHODS: Consecutive patients with STEMI undergoing primary PCI in a tertiary care high-volume radial centre were included. TRA-PCI failure was categorised as primary (primary transfemoral approach (TFA)) or crossover (from TRA to TFA)...
June 15, 2016: Heart: Official Journal of the British Cardiac Society
Mamas A Mamas, James Nolan, Mark A de Belder, Azfar Zaman, Tim Kinnaird, Nick Curzen, Chun Shing Kwok, Iain Buchan, Peter Ludman, Evangelos Kontopantelis
BACKGROUND: The transradial access (TRA) site has become the default access site for percutaneous coronary intervention in the United Kingdom, with randomized trials and national registry data showing reductions in mortality associated with TRA use. This study evaluates regional changes in access site practice in England and Wales over time, examines whether changes in access site practice have been uniform nationally and across different patient subgroups, and provides national estimates for the potential number of lives saved or lost associated with regional differences in access site practice...
April 26, 2016: Circulation
Harold L Dauerman
No abstract text is available yet for this article.
April 26, 2016: Circulation
Andrea Santucci, Giuseppe Gargiulo, Sara Ariotti, Marcello Marino, Giulia Magnani, Andrea Baldo, Raffaele Piccolo, Anna Franzone, Marco Valgimigli
Radial approach has been used since 1989 to perform coronary angiography as an alternative to femoral access. During past decades, the development of dedicated equipment has led to high efficacy also in complex procedures. ST elevation myocardial infarction (STEMI) is known to be a high bleeding risk setting and in turn bleeding events can negatively impact on outcomes. Observational studies have demonstrated feasibility, efficacy and safety of radial approach when compared to femoral access in STEMI patients, with benefit in bleeding rates...
June 2016: Minerva Cardioangiologica
Ernesto Ruiz-Rodriguez, Ahmed Asfour, Georges Lolay, Khaled M Ziada, Ahmed K Abdel-Latif
OBJECTIVES: Radial artery access (RA) for left heart catheterization and percutaneous coronary interventions (PCIs) has been demonstrated to be safe and effective. Despite consistent data showing less bleeding complications compared with femoral artery access (FA), it continues to be underused in the United States, particularly in patients with acute coronary syndrome (ACS) in whom aggressive anticoagulation and platelet inhibition regimens are needed. This systematic review and meta-analysis aims to compare major cardiovascular outcomes and safety endpoints in patients with ACS managed with PCI using radial versus femoral access...
January 2016: Southern Medical Journal
Mitul B Kadakia, Sunil V Rao, Lisa McCoy, Paramita S Choudhuri, Matthew W Sherwood, Scott Lilly, Taisei Kobayashi, Daniel M Kolansky, Robert L Wilensky, Robert W Yeh, Jay Giri
OBJECTIVES: The purpose of this study was to assess usage patterns of transradial access in rescue percutaneous coronary intervention (PCI) for ST-segment elevation myocardial infarction (STEMI) and associations between vascular access site choice and outcomes. BACKGROUND: Transradial access reduces bleeding and mortality in STEMI patients undergoing primary PCI. Little is known about access site choice and outcomes in patients undergoing rescue PCI after receiving full-dose fibrinolytic therapy for STEMI...
December 21, 2015: JACC. Cardiovascular Interventions
Francesco Burzotta, Marta Francesca Brancati, Italo Porto, Silvia Saffioti, Cristina Aurigemma, Giampaolo Niccoli, Antonio Maria Leone, Valentina Coluccia, Filippo Crea, Carlo Trani
BACKGROUND: Transradial approach (TRA), when compared with transfemoral, improves the safety of percutaneous coronary procedures. Arterial axis variants are known to hinder the performance of transradial approach percutaneous coronary procedures. Data on the occurrence of arterial axis variants in the right and left arm arterial axes of individual patients are lacking. METHODS AND RESULTS: From a single-center prospective registry, we selected all patients in whom bilateral upper limb arterial anatomy was assessed based on the performance of left and right radial catheterization obtained during the same or during repeat coronary diagnostic or interventional procedure(s)...
December 2015: Circulation. Cardiovascular Interventions
Lorenzo Azzalini, Kunle Tosin, Malorie Chabot-Blanchet, Robert Avram, Hung Q Ly, Benoit Gaudet, Richard Gallo, Serge Doucet, Jean-François Tanguay, Réda Ibrahim, Jean C Grégoire, Jacques Crépeau, Raoul Bonan, Pierre de Guise, Mohamed Nosair, Jean-François Dorval, Gilbert Gosselin, Philippe L L'Allier, Marie-Claude Guertin, Anita W Asgar, E Marc Jolicœur
OBJECTIVES: The purpose of this study was to assess whether the benefits conferred by radial access (RA) at an individual level are offset by a proportionally greater incidence of vascular access site complications (VASC) at a population level when femoral access (FA) is performed. BACKGROUND: The recent widespread adoption of RA for cardiac catheterization has been associated with increased rates of VASCs when FA is attempted. METHODS: Logistic regression was used to calculate the adjusted VASC rate in a contemporary cohort of consecutive patients (2006 to 2008) where both RA and FA were used, and compared it with the adjusted VASC rate observed in a historical control cohort (1996 to 1998) where only FA was used...
December 21, 2015: JACC. Cardiovascular Interventions
Praveen Maheshwari, Bradley Kelsheimer, Parul Maheshwari
No abstract text is available yet for this article.
April 2016: Canadian Journal of Anaesthesia
Giuseppe Andò, Davide Capodanno
BACKGROUND: Studies in patients with acute coronary syndrome (ACS) undergoing invasive management showed conflicting conclusions regarding the effect of access site on outcomes. PURPOSE: To summarize evidence from recent, high-quality trials that compared clinical outcomes occurring with radial versus femoral access in invasively managed adults with ACS. DATA SOURCES: English-language publications in MEDLINE, EMBASE, and Cochrane databases between January 1990 and August 2015...
December 15, 2015: Annals of Internal Medicine
Warren J Cantor, Dennis T Ko, Madhu K Natarajan, Vladimír Džavík, Harindra C Wijeysundera, Julie T Wang, Kori J Kingsbury, James L Velianou, Eric A Cohen, Michel R Le May, Jack V Tu
BACKGROUND: Radial access is associated with less bleeding and vascular complications. However, it may delay reperfusion during primary percutaneous coronary intervention for ST-segment-elevation myocardial infarction. METHODS AND RESULTS: A provincial database prospectively collected clinical and procedural characteristics for all urgent percutaneous coronary intervention procedures performed between June 2010 and September 2011 in Ontario for ST-segment-elevation myocardial infarction, including time of arrival in the catheterization laboratory and time of first balloon inflation...
May 2015: Circulation. Cardiovascular Interventions
Marco Valgimigli, Andrea Gagnor, Paolo Calabró, Enrico Frigoli, Sergio Leonardi, Tiziana Zaro, Paolo Rubartelli, Carlo Briguori, Giuseppe Andò, Alessandra Repetto, Ugo Limbruno, Bernardo Cortese, Paolo Sganzerla, Alessandro Lupi, Mario Galli, Salvatore Colangelo, Salvatore Ierna, Arturo Ausiello, Patrizia Presbitero, Gennaro Sardella, Ferdinando Varbella, Giovanni Esposito, Andrea Santarelli, Simone Tresoldi, Marco Nazzaro, Antonio Zingarelli, Nicoletta de Cesare, Stefano Rigattieri, Paolo Tosi, Cataldo Palmieri, Salvatore Brugaletta, Sunil V Rao, Dik Heg, Martina Rothenbühler, Pascal Vranckx, Peter Jüni
BACKGROUND: It is unclear whether radial compared with femoral access improves outcomes in unselected patients with acute coronary syndromes undergoing invasive management. METHODS: We did a randomised, multicentre, superiority trial comparing transradial against transfemoral access in patients with acute coronary syndrome with or without ST-segment elevation myocardial infarction who were about to undergo coronary angiography and percutaneous coronary intervention...
June 20, 2015: Lancet
M Bilal Iqbal, Aruna Arujuna, Charles Ilsley, Andrew Archbold, Tom Crake, Sam Firoozi, Sundeep Kalra, Charles Knight, Pitt Lim, Iqbal S Malik, Anthony Mathur, Pascal Meier, Roby D Rakhit, Simon Redwood, Mark Whitbread, Dan Bromage, Krishna Rathod, Andrew Wragg, Philip MacCarthy, Miles Dalby
BACKGROUND: Compared with transfemoral access, transradial access (TRA) for percutaneous coronary intervention is associated with reduced risk of bleeding and vascular complications. Studies suggest that TRA may reduce mortality in patients with ST-segment-elevation myocardial infarction. However, there are few data on the effect of TRA on mortality, specifically, in patients with non-ST-segment-elevation myocardial infarction. METHODS AND RESULTS: We analyzed 10 095 consecutive patients with non-ST-segment-elevation myocardial infarction treated with percutaneous coronary intervention between 2005 and 2011 in all 8 tertiary cardiac centers in London, United Kingdom...
August 2014: Circulation. Cardiovascular Interventions
Edward L Hannan, Louise Szypulski Farrell, Gary Walford, Peter B Berger, Nicholas J Stamato, Ferdinand J Venditti, Alice K Jacobs, David R Holmes, Samin Sharma, Spencer B King
OBJECTIVES: This study sought to determine the utilization and outcomes for radial access for percutaneous coronary intervention (PCI) for ST-segment elevation acute myocardial infarction (STEMI) in common practice. BACKGROUND: Radial access for PCI has been studied considerably, but mostly in clinical trials. METHODS: All patients undergoing PCI for STEMI in 2009 to 2010 in New York were studied to determine the frequency and the patient-level predictors of radial access...
March 2014: JACC. Cardiovascular Interventions
Sanjit S Jolly, John Cairns, Salim Yusuf, Kari Niemela, Philippe Gabriel Steg, Matthew Worthley, Emile Ferrari, Warren J Cantor, Anthony Fung, Nicholas Valettas, Michael Rokoss, Goran K Olivecrona, Petr Widimsky, Asim N Cheema, Peggy Gao, Shamir R Mehta
OBJECTIVES: The study sought to evaluate the relationship between procedural volume and outcomes with radial and femoral approach. BACKGROUND: RIVAL (RadIal Vs. femorAL) was a randomized trial of radial versus femoral access for coronary angiography/intervention (N = 7,021), which overall did not show a difference in primary outcome of death, myocardial infarction, stroke, or non-coronary artery bypass graft major bleeding. METHODS: In pre-specified subgroup analyses, the hazard ratios for the primary outcome were compared among centers divided by tertiles and among individual operators...
March 18, 2014: Journal of the American College of Cardiology
Wassef Karrowni, Ankur Vyas, Bria Giacomino, Marin Schweizer, Amy Blevins, Saket Girotra, Phillip A Horwitz
OBJECTIVES: This study sought to determine the safety and efficacy of radial access compared with femoral access for primary percutaneous coronary intervention (PCI) in patients with ST-segment elevation myocardial infarction (STEMI). BACKGROUND: Numerous randomized controlled trials, including several new studies, have compared outcomes of these approaches in the context of primary PCI for STEMI patients with inconclusive results. METHODS: We performed a meta-analysis of randomized controlled trials to compare outcomes in STEMI patients undergoing radial versus femoral access for primary PCI...
August 2013: JACC. Cardiovascular Interventions
2016-01-06 07:43:36
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