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Predictors of Conversion from Radial Into Femoral Access in Cardiac Catheterization.

Carvalho MS, Calé R, Gonçalves Pde A, Vinhas H, Raposo L, Teles R, Martins C, Gabriel HM, Pereira H, Almeida M - Arq. Bras. Cardiol. (2015)

Bottom Line: However, transradial (TR) approach is not always successful, requiring its conversion into femoral access.Radial access failure rate was 5.8%.Female sex, older age, smaller BSA, the use of short introducer sheaths, multivessel disease and PCI were independent predictors of conversion into femoral access.

View Article: PubMed Central - PubMed

Affiliation: Hospital de Santa Cruz, Portugal.

ABSTRACT

Background: Fewer bleeding complications and early ambulation make radial access a privileged route for cardiac catheterization. However, transradial (TR) approach is not always successful, requiring its conversion into femoral access.

Objectives: To evaluate the rate of conversion from radial into femoral access in cardiac catheterization and to identify its predictors.

Methods: Prospective dual-center registry, including 7632 consecutive patients undergoing catheterization via the radial access between Jan/2009 and Oct/2012. We evaluated the incidence of conversion into femoral access and its predictors by logistic regression analysis.

Results: The patients' mean age was 66 ± 11 years, and 32% were women. A total of 2969 procedures (38.4%) were percutaneous coronary interventions (PCI), and the most used first intention arterial access was the right radial artery (97.6%). Radial access failure rate was 5.8%. Independent predictors of conversion from radial into femoral access were the use of short introducer sheaths (OR 3.047, CI: 2.380-3.902; p < 0.001), PCI (OR 1.729, CI: 1.375-2.173; p < 0.001), female sex (OR 1.569, CI: 1.234-1.996; p < 0.001), multivessel disease (OR 1.457, CI: 1.167-1.819; p = 0.001), body surface area (BSA) ≤ 1.938 (OR 1.448, CI: 1.120-1.871; p = 0.005) and age > 66 years (OR 1.354, CI: 1.088-1.684; p = 0.007).

Conclusion: Transradial approach for cardiac catheterization has a high success rate and the need for its conversion into femoral access in this cohort was low. Female sex, older age, smaller BSA, the use of short introducer sheaths, multivessel disease and PCI were independent predictors of conversion into femoral access.

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Related in: MedlinePlus

Patient selection and study design.
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f01: Patient selection and study design.

Mentions: In a prospective registry of 14750 consecutive patients from two centres, whounderwent cardiac catheterization for diagnostic or interventional coronaryprocedures, between January 2009 and October 2012, we selected for the purpose ofthis analysis all consecutive patients in whom the first intention was to use theradial artery (n = 7664). Of these patients, we excluded those in whom the radialaccess failed, and the alternative choice was the contralateral radial (n = 26), thehumeral (n = 4) and the cubital artery (n = 2) (Figure1).


Predictors of Conversion from Radial Into Femoral Access in Cardiac Catheterization.

Carvalho MS, Calé R, Gonçalves Pde A, Vinhas H, Raposo L, Teles R, Martins C, Gabriel HM, Pereira H, Almeida M - Arq. Bras. Cardiol. (2015)

Patient selection and study design.
© Copyright Policy - open-access
Related In: Results  -  Collection

License
Show All Figures
getmorefigures.php?uid=PMC4495455&req=5

f01: Patient selection and study design.
Mentions: In a prospective registry of 14750 consecutive patients from two centres, whounderwent cardiac catheterization for diagnostic or interventional coronaryprocedures, between January 2009 and October 2012, we selected for the purpose ofthis analysis all consecutive patients in whom the first intention was to use theradial artery (n = 7664). Of these patients, we excluded those in whom the radialaccess failed, and the alternative choice was the contralateral radial (n = 26), thehumeral (n = 4) and the cubital artery (n = 2) (Figure1).

Bottom Line: However, transradial (TR) approach is not always successful, requiring its conversion into femoral access.Radial access failure rate was 5.8%.Female sex, older age, smaller BSA, the use of short introducer sheaths, multivessel disease and PCI were independent predictors of conversion into femoral access.

View Article: PubMed Central - PubMed

Affiliation: Hospital de Santa Cruz, Portugal.

ABSTRACT

Background: Fewer bleeding complications and early ambulation make radial access a privileged route for cardiac catheterization. However, transradial (TR) approach is not always successful, requiring its conversion into femoral access.

Objectives: To evaluate the rate of conversion from radial into femoral access in cardiac catheterization and to identify its predictors.

Methods: Prospective dual-center registry, including 7632 consecutive patients undergoing catheterization via the radial access between Jan/2009 and Oct/2012. We evaluated the incidence of conversion into femoral access and its predictors by logistic regression analysis.

Results: The patients' mean age was 66 ± 11 years, and 32% were women. A total of 2969 procedures (38.4%) were percutaneous coronary interventions (PCI), and the most used first intention arterial access was the right radial artery (97.6%). Radial access failure rate was 5.8%. Independent predictors of conversion from radial into femoral access were the use of short introducer sheaths (OR 3.047, CI: 2.380-3.902; p < 0.001), PCI (OR 1.729, CI: 1.375-2.173; p < 0.001), female sex (OR 1.569, CI: 1.234-1.996; p < 0.001), multivessel disease (OR 1.457, CI: 1.167-1.819; p = 0.001), body surface area (BSA) ≤ 1.938 (OR 1.448, CI: 1.120-1.871; p = 0.005) and age > 66 years (OR 1.354, CI: 1.088-1.684; p = 0.007).

Conclusion: Transradial approach for cardiac catheterization has a high success rate and the need for its conversion into femoral access in this cohort was low. Female sex, older age, smaller BSA, the use of short introducer sheaths, multivessel disease and PCI were independent predictors of conversion into femoral access.

Show MeSH
Related in: MedlinePlus