TY  - BOOK
AU  - Baker, Nevin C
AU  - Ben-Dor, Itsik
AU  - Bernardo, Nelson L
AU  - Escarcega, Ricardo O
AU  - Gaglia, Michael AJ
AU  - Gai, Jiaxiang
AU  - Gallino, Robert
AU  - Kiramijyan, Starkis
AU  - Koifman, Edward
AU  - Lager, Robert A
AU  - Lipinski, Michael J
AU  - Negi, Smita I
AU  - Pichard, Augusto D
AU  - Satler, Lowell F
AU  - Suddath, William O
AU  - Torguson, Rebecca
AU  - Waksman, Ron
TI  - Comparison of transradial and transfemoral access in patients undergoing percutaneous coronary intervention for complex coronary lesions
SN  - 1522-1946
PY  - 2017///
KW  - *Acute Coronary Syndrome/su [Surgery]
KW  - *Catheterization, Peripheral/mt [Methods]
KW  - *Percutaneous Coronary Intervention/mt [Methods]
KW  - *Postoperative Complications/ep [Epidemiology]
KW  - Acute Coronary Syndrome/di [Diagnosis]
KW  - Aged
KW  - Cause of Death/td [Trends]
KW  - Coronary Angiography
KW  - District of Columbia/ep [Epidemiology]
KW  - Electrocardiography
KW  - Female
KW  - Femoral Artery
KW  - Follow-Up Studies
KW  - Humans
KW  - Incidence
KW  - Male
KW  - Middle Aged
KW  - Prognosis
KW  - Radial Artery
KW  - Retrospective Studies
KW  - Time Factors
KW  - MedStar Health Research Institute
KW  - MedStar Heart & Vascular Institute
KW  - Comparative Study
KW  - Journal Article
N1  - Available online from MWHC library: 1996 - present, Available in print through MWHC library: 1996 - 2006
N2  - 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
UR  - https://dx.doi.org/10.1002/ccd.26669
ER  -