| Coronary angiography in the fully anticoagulated patient: the transradial route is successful and safe. | |
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MedLine Citation:
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PMID: 12508189 Owner: NLM Status: MEDLINE |
Abstract/OtherAbstract:
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The radial approach to coronary angiography is intuitively attractive for fully anticoagulated patients (INR > 2) but no data exist concerning efficacy or safety of this procedure. The consensus view is that the femoral approach is contraindicated in fully anticoagulated patients, and though some operators undertake femoral catheterization in such patients and use closure devices, there are no data to suggest that it is safe to do so. At our institution, the radial approach for coronary angiography is reserved for patients in whom there is a relative contraindication to the femoral route. We have undertaken over 600 radial coronary angiograms in such patients since 1996, 66 of whom underwent transradial catheterization specifically because of anticoagulation status (INR > 2). Thirty-eight patients (58%) were male, average age 67 +/- 11 years. All 66 patients had an INR > 2 but < 4.5. The approach was left radial in 26 (39%), right radial in the remainder; sheath size was 4 Fr in 4 (6%), 5 Fr in 13 (20%), and 6 Fr in 49 (74%). Seven operators in total were involved, though two operators undertook the majority of cases (47; 71%). Success rate was 97%, with no failure of access, and only one minor postprocedural hemorrhage. Failures were due to radial artery atherosclerosis (1) and subclavian tortuosity (1). The radial approach to coronary angiography is safe and to be recommended in the fully anticoagulated patient. |
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Authors:
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David J R Hildick-Smith; John T Walsh; Martin D Lowe; Michael C Petch |
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Publication Detail:
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Type: Journal Article |
Journal Detail:
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Title: Catheterization and cardiovascular interventions : official journal of the Society for Cardiac Angiography & Interventions Volume: 58 ISSN: 1522-1946 ISO Abbreviation: Catheter Cardiovasc Interv Publication Date: 2003 Jan |
Date Detail:
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Created Date: 2002-12-31 Completed Date: 2003-04-18 Revised Date: 2004-11-17 |
Medline Journal Info:
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Nlm Unique ID: 100884139 Medline TA: Catheter Cardiovasc Interv Country: United States |
Other Details:
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Languages: eng Pagination: 8-10 Citation Subset: IM |
Copyright Information:
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Copyright 2003 Wiley-Liss, Inc. |
Affiliation:
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Department of Cardiology, Papworth Hospital, Cambridgeshire, UK. djrhs@waitrose.com |
Export Citation:
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APA/MLA Format Download EndNote Download BibTex |
| MeSH Terms | |
Descriptor/Qualifier:
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Aged Anticoagulants / adverse effects, therapeutic use* Coronary Angiography / adverse effects*, contraindications Coronary Disease / drug therapy*, radiography* Female Humans Male Middle Aged Outcome Assessment (Health Care) Postoperative Complications* Radial Artery / drug effects, radiography, surgery* Retrospective Studies Vascular Diseases / etiology* |
| Chemical | |
Reg. No./Substance:
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0/Anticoagulants |
From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine
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