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Comparison of Radial Access, Guided Femoral Access, and Non-Guided Femoral Access Among Women Undergoing Percutaneous Coronary Intervention.

Publication ,  Journal Article
Koshy, LM; Aberle, LH; Krucoff, MW; Hess, CN; Mazzaferri, E; Jolly, SS; Jacobs, A; Gibson, CM; Mehran, R; Gilchrist, IC; Rao, SV
Published in: The Journal of invasive cardiology
January 2018

This study was conducted to determine the association between radial access, guided femoral access, and non-guided femoral access on postprocedural bleeding and vascular complications after percutaneous coronary intervention (PCI).Bleeding events and major vascular complications after PCI are associated with increased morbidity, mortality, and cost. While the radial approach has been shown to be superior to the femoral approach in reducing bleeding and vascular complications, whether the use of micropuncture, fluoroscopy, or ultrasound mitigates these differences is unknown.We conducted a post hoc analysis of women in the SAFE-PCI for Women trial who underwent PCI and had the access method identified (n = 643). The primary endpoint of postprocedure bleeding or vascular complications occurring within 72 hours or at discharge was adjudicated by an independent clinical events committee and was compared based on three categories of access technique: radial, guided femoral (fluoroscopy, micropuncture, ultrasound), or non-guided femoral (none of the aforementioned). Differences between the groups were determined using multivariate logistic regression using radial access as the reference.Of the PCI population, 330 underwent radial access, 228 underwent guided femoral access, and 85 underwent non-guided femoral access. There was a statistically significant lower incidence of the primary endpoint with radial access vs non-guided femoral access; however, there was no significant difference between radial approach and femoral access guided by fluoroscopy, micropuncture, or ultrasound.This post hoc analysis demonstrates that while radial access is safer than non-guided femoral access, guided femoral access appears to be associated with similar bleeding events or vascular complications as radial access.

Duke Scholars

Published In

The Journal of invasive cardiology

EISSN

1557-2501

ISSN

1042-3931

Publication Date

January 2018

Volume

30

Issue

1

Start / End Page

18 / 22

Related Subject Headings

  • Vascular System Injuries
  • Surgery, Computer-Assisted
  • Radial Artery
  • Percutaneous Coronary Intervention
  • Middle Aged
  • Intraoperative Complications
  • Humans
  • Hemorrhage
  • Femoral Artery
  • Female
 

Citation

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ICMJE
MLA
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Koshy, L. M., Aberle, L. H., Krucoff, M. W., Hess, C. N., Mazzaferri, E., Jolly, S. S., … Rao, S. V. (2018). Comparison of Radial Access, Guided Femoral Access, and Non-Guided Femoral Access Among Women Undergoing Percutaneous Coronary Intervention. The Journal of Invasive Cardiology, 30(1), 18–22.
Koshy, Linda M., Laura H. Aberle, Mitchell W. Krucoff, Connie N. Hess, Ernest Mazzaferri, Sanjit S. Jolly, Alice Jacobs, et al. “Comparison of Radial Access, Guided Femoral Access, and Non-Guided Femoral Access Among Women Undergoing Percutaneous Coronary Intervention.The Journal of Invasive Cardiology 30, no. 1 (January 2018): 18–22.
Koshy LM, Aberle LH, Krucoff MW, Hess CN, Mazzaferri E, Jolly SS, et al. Comparison of Radial Access, Guided Femoral Access, and Non-Guided Femoral Access Among Women Undergoing Percutaneous Coronary Intervention. The Journal of invasive cardiology. 2018 Jan;30(1):18–22.
Koshy, Linda M., et al. “Comparison of Radial Access, Guided Femoral Access, and Non-Guided Femoral Access Among Women Undergoing Percutaneous Coronary Intervention.The Journal of Invasive Cardiology, vol. 30, no. 1, Jan. 2018, pp. 18–22.
Koshy LM, Aberle LH, Krucoff MW, Hess CN, Mazzaferri E, Jolly SS, Jacobs A, Gibson CM, Mehran R, Gilchrist IC, Rao SV. Comparison of Radial Access, Guided Femoral Access, and Non-Guided Femoral Access Among Women Undergoing Percutaneous Coronary Intervention. The Journal of invasive cardiology. 2018 Jan;30(1):18–22.

Published In

The Journal of invasive cardiology

EISSN

1557-2501

ISSN

1042-3931

Publication Date

January 2018

Volume

30

Issue

1

Start / End Page

18 / 22

Related Subject Headings

  • Vascular System Injuries
  • Surgery, Computer-Assisted
  • Radial Artery
  • Percutaneous Coronary Intervention
  • Middle Aged
  • Intraoperative Complications
  • Humans
  • Hemorrhage
  • Femoral Artery
  • Female