Comparison of transradial and transfemoral access in patients undergoing percutaneous coronary intervention for complex coronary lesions. 

 -  2017 
<br/><br/>Available online from MWHC library: 1996 - present, Available in print through MWHC library: 1996 - 2006 
<br/><br/> 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.  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.  Copyright © 2016 Wiley Periodicals, Inc.  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.  OBJECTIVE: Comparison of transradial versus transfemoral access for complex percutaneous coronary intervention (PCI) with regard to both complications and long-term 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. 
<br/><br/><br/>English 
<br/><br/><label>ISSN: </label>1522-1946 
<br/><br/><label>Subjects--Topical Terms: </label><br/>*Acute Coronary Syndrome/su [Surgery]<br/>*Catheterization, Peripheral/mt [Methods]<br/>*Percutaneous Coronary Intervention/mt [Methods]<br/>*Postoperative Complications/ep [Epidemiology]<br/>Acute Coronary Syndrome/di [Diagnosis]<br/>Aged<br/>Cause of Death/td [Trends]<br/>Coronary Angiography<br/>District of Columbia/ep [Epidemiology]<br/>Electrocardiography<br/>Female<br/>Femoral Artery<br/>Follow-Up Studies<br/>Humans<br/>Incidence<br/>Male<br/>Middle Aged<br/>Prognosis<br/>Radial Artery<br/>Retrospective Studies<br/>Time Factors
<br/><br/><label>Subjects--Geographic Terms: </label><br/>MedStar Health Research Institute<br/>MedStar Heart & Vascular Institute
<br/><br/><label>Index Terms--Function: </label><br/>Comparative Study<br/>Journal Article