In:
Catheterization and Cardiovascular Interventions, Wiley, Vol. 89, No. 4 ( 2017-03), p. 640-646
Kurzfassung:
Comparison of transradial versus transfemoral access for complex percutaneous coronary intervention (PCI) with regard to both complications and long‐term outcomes. Background Radial access has been shown to confer superior results in patients undergoing PCI, especially in patients with acute coronary syndromes. However, radial access has limitations of sheath and device size, which may increase procedure time and result in inferior outcomes. Methods Patients undergoing PCI for complex lesions, defined as type C according the ACC/AHA classification system, were included in this study. Propensity matching was performed to adjust for differences in baseline characteristics. Transradial patients were then compared to transfemoral patients in regard to procedural, in‐hospital, and 6‐month outcomes. Results Among 2142 patients with 2591 lesions treated, 1876 had femoral access and 267 had radial access. Radial access patients were more likely to be male (75% vs. 66%, P = 0.003) and less likely to present with acute myocardial infarction (27% vs. 42%, P 〈 0.001). Procedural characteristics demonstrated lower use of heparin in the femoral group (17% vs. 73%, P 〈 0.001) with similarly low use of glycoprotein inhibitors (5.6% vs. 3.4%, P = 0.14). Patients in the femoral group had higher rates of transfusions (3.7% vs. 0%, P = 0.004) and vascular complications (1.7% vs. 0%, P = 0.03). Following propensity matching, there was no difference in mid‐term outcomes between radial and femoral groups. Conclusions In patients with complex coronary lesions undergoing PCI, the radial approach demonstrates similar mid‐term outcomes as the femoral approach with a potentially lower rate of complications. © 2016 Wiley Periodicals, Inc.
Materialart:
Online-Ressource
ISSN:
1522-1946
,
1522-726X
Sprache:
Englisch
Verlag:
Wiley
Publikationsdatum:
2017
ZDB Id:
2001555-0
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