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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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Radial access failure over the years.
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f04: Radial access failure over the years.

Mentions: Over the years, as expected, the use of radial access had a gradual increase: 25% in2009 to 76% in 2012 (Figure 3A). Focusing onradial access failure rates, one could anticipate a decrease with greater experience.Nonetheless, failure rate was higher in the last years and this could be explained bythe fact that higher operator experience could have been offset by a widespread use ofthe technique, even in less favorable situations to the transradial approach (Figure 3B).


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)

Radial access failure over the years.
© Copyright Policy - open-access
Related In: Results  -  Collection

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

f04: Radial access failure over the years.
Mentions: Over the years, as expected, the use of radial access had a gradual increase: 25% in2009 to 76% in 2012 (Figure 3A). Focusing onradial access failure rates, one could anticipate a decrease with greater experience.Nonetheless, failure rate was higher in the last years and this could be explained bythe fact that higher operator experience could have been offset by a widespread use ofthe technique, even in less favorable situations to the transradial approach (Figure 3B).

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