Document Detail


Transradial access in a cath lab with moderate procedural volume: a single operator's experience.
MedLine Citation:
PMID:  17534248     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
AIM: The transradial access (TRA) for cardiovascular interventions has become increasingly popular and was shown to be effective in many clinical settings, including acute coronary syndromes. Despite offering many advantages, such as a striking reduction in access site complications, the penetration of TRA in routine practice is still low. One reason for this could be that many studies about TRA were performed in high-volume centers by expert operators, making their results not fully applicable to the real world. In order to assess the efficacy of TRA, we retrospectively reviewed the caseload of a single operator working in a community hospital with moderate procedural volume. METHODS: We considered 873 consecutive procedures, of which 406 percutaneous coronary interventions (PCI), performed by a single operator (S.R.) who had previously completed the learning curve in TRA at a high volume center. RESULTS: TRA was selected in 48.3% of patients, transfemoral approach (TFA) in 50.9% and transbrachial approach in 0.8%. TFA was used more frequently in PCI (62.5% vs 37.5%; P<0.001), largely because it was the access of choice in primary PCI. The overall procedural success rate was 94% in TRA and 98% in TFA (P=0.035); access failure was more frequent in TRA (5.9% vs 1.1%; P<0.001), whereas an increased rate of access-related vascular complications was observed in TFA as compared to TRA (1.1% vs 0%; P=0.029). CONCLUSION: After an adequate training period, the overall performance of TRA is good even in moderate-volume hospitals. Despite reducing access site complications, TRA is limited by a slightly higher rate of procedural failure as compared to TFA.
Authors:
S Rigattieri; G Ferraiuolo; P Loschiavo
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Publication Detail:
Type:  Comparative Study; Journal Article    
Journal Detail:
Title:  Minerva cardioangiologica     Volume:  55     ISSN:  0026-4725     ISO Abbreviation:  Minerva Cardioangiol     Publication Date:  2007 Jun 
Date Detail:
Created Date:  2007-05-30     Completed Date:  2007-10-09     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  0400725     Medline TA:  Minerva Cardioangiol     Country:  Italy    
Other Details:
Languages:  eng     Pagination:  303-9     Citation Subset:  IM    
Affiliation:
Cardiology Department, Sandro Pertini Hospital, Rome, Italy. stefanorigattieri@yahoo.it
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MeSH Terms
Descriptor/Qualifier:
Acute Disease
Aged
Aged, 80 and over
Angioplasty, Transluminal, Percutaneous Coronary / methods*
Cardiology Service, Hospital
Catheterization, Peripheral
Coronary Angiography / methods*
Coronary Disease / radiography,  surgery,  therapy*
Female
Femoral Artery / surgery
Humans
Male
Middle Aged
Radial Artery / surgery*
Retrospective Studies
Stents*

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


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