Document Detail


Fluoroscopy vs. traditional guided femoral arterial access and the use of closure devices: a randomized controlled trial.
MedLine Citation:
PMID:  19626694     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
OBJECTIVE: To compare the effectiveness of accessing the common femoral artery (CFA) using fluoroscopic guidance (FG) versus traditional anatomic landmark guidance (TALG) during cardiac catheterization and to determine the effect of the two modalities on the appropriateness for use of vascular closure devices (VCDs). BACKGROUND: Previous studies have shown a consistent relationship between the head of the femur and the CFA, yet there is no prospective data validating the superiority of fluoroscopy-assisted CFA access. METHODS: A total of 972 patients were randomized to either FG or TALG access. The primary endpoint of the study was the angiographic suitability of the puncture site for VCD use. Secondary endpoints included arteriotomy location, time and number of attempts needed to obtain access, and the incidence of vascular complications. RESULTS: Of these, 474 patients were randomized into the FG arm and 498 patients into the TALG arm. A total of 79.5% of patients in the fluoroscopy arm and 80.7% in the traditional arm (P = 0.7) were deemed angiographically suitable for VCD based on the arteriotomy. The fluoroscopy group had significantly less arteriotomies below the inferior border of the head of the femur (P = 0.03). Total time for sheath insertion (105.7 +/- 130.7 vs. 106.5 +/- 152.6 sec) and number of arterial punctures (1.1 +/- 0.4 vs. 1.1 +/- 0.5) did not differ among the FG and TALG, respectively. The rates of vascular complications were not different. CONCLUSION: The angiographic suitability for VCD was not different between FG and TALG groups. Fluoroscopy decreased the number of low arteriotomies. The time to sheath insertion, number of arterial punctures needed to obtain access, and the incidence of complications were also similar.
Authors:
Mazen S Abu-Fadel; Jeffrey M Sparling; Soni J Zacharias; Christopher E Aston; Jorge F Saucedo; Eliot Schechter; Thomas A Hennebry
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Publication Detail:
Type:  Comparative Study; Journal Article; Randomized Controlled Trial; Research Support, N.I.H., Extramural; Research Support, Non-U.S. Gov't    
Journal Detail:
Title:  Catheterization and cardiovascular interventions : official journal of the Society for Cardiac Angiography & Interventions     Volume:  74     ISSN:  1522-726X     ISO Abbreviation:  Catheter Cardiovasc Interv     Publication Date:  2009 Oct 
Date Detail:
Created Date:  2009-10-05     Completed Date:  2009-12-11     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  100884139     Medline TA:  Catheter Cardiovasc Interv     Country:  United States    
Other Details:
Languages:  eng     Pagination:  533-9     Citation Subset:  IM    
Affiliation:
Department of Internal Medicine, University of Oklahoma College of Medicine, Oklahoma City, OK 73104, USA. mazen-abufadel@ouhsc.edu
Data Bank Information
Bank Name/Acc. No.:
ClinicalTrials.gov/NCT00222430
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MeSH Terms
Descriptor/Qualifier:
Aged
Body Mass Index
Equipment Design
Female
Femoral Artery / radiography*
Femur Head
Fluoroscopy*
Heart Catheterization / adverse effects,  instrumentation,  methods*
Hemorrhage / etiology,  prevention & control*
Hemostatic Techniques / instrumentation*
Humans
Male
Middle Aged
Prospective Studies
Punctures
Radiography, Interventional*
Sex Factors
Treatment Outcome
Grant Support
ID/Acronym/Agency:
M01-RR-14467/RR/NCRR NIH HHS
Comments/Corrections
Comment In:
Catheter Cardiovasc Interv. 2009 Oct 1;74(4):540-2   [PMID:  19780060 ]

From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine


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