Predictors of Access Site Crossover in Patients Who Underwent Transradial Coronary Angiography.
Am J Cardiol
; 116(3): 379-83, 2015 Aug 01.
Article
en En
| MEDLINE
| ID: mdl-26026865
ABSTRACT
Despite increasing use of the transradial approach (TRA) for coronary angiography, TRA failure and subsequent access site crossover remain a barrier to TRA adoption. The aim of this study was to elucidate patient and procedural characteristics associated with TRA to transfemoral approach (TFA) crossover and examine TRA to TFA crossover by operator experience over time. This retrospective analysis identified 1,600 patients who underwent coronary angiography with possible percutaneous coronary intervention through TRA by operators with varied TRA experience in an urban tertiary care center from October 2010 to August 2013. Univariate and multivariable logistic regression were used to identify independent predictors of access site crossover, from TRA to TFA, and strength of association is presented as odds ratio (OR, 95% confidence interval [CI]). Access site crossover was noted in 166 patients (10.4%). Multivariable predictors of access site crossover included age >75 years (OR 1.90, 95% CI 1.23 to 2.91, p = 0.004) and operator experience (OR 2.98, 95% CI 1.96 to 4.52, p <0.0001). Less experienced operators (≤5 years TRA experience) had a decrease in access site crossover over time (quartile 1 8.9%, quartile 2 18.8%, quartile 3 16.4%, and quartile 4 8.6%, p <0.001), which paralleled an increase in the proportion of procedures using initial TRA over time (quartile 1 38.0%, quartile 2 53.7%, quartile 3 54.8%, and quartile 4 70.3%, p <0.001). Experienced operators (>5 years TRA experience) had no significant change in proportion of access site crossover over time (quartile 1 2.8%, quartile 2 6.4%, quartile 3 5.6%, quartile 4 5.8%, p = 0.54). In conclusion, rate of access site crossover in the contemporary era is relatively low and can be mitigated with operator experience.
Texto completo:
1
Colección:
01-internacional
Banco de datos:
MEDLINE
Asunto principal:
Enfermedad de la Arteria Coronaria
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Cateterismo Periférico
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Angiografía Coronaria
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Intervención Coronaria Percutánea
Tipo de estudio:
Observational_studies
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Prognostic_studies
Límite:
Aged
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Female
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Humans
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Male
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Middle aged
Idioma:
En
Revista:
Am J Cardiol
Año:
2015
Tipo del documento:
Article