| Transradial versus transfemoral artery approach for coronary angiography and percutaneous coronary intervention in the extremely obese. | |
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MedLine Citation:
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PMID: 22917453 Owner: NLM Status: In-Data-Review |
Abstract/OtherAbstract:
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OBJECTIVES: This study sought to evaluate the safety and efficacy of transradial versus transfemoral access for coronary angiography and percutaneous coronary intervention in patients with a body mass index ≥40 kg/m(2). BACKGROUND: Coronary angiography is most commonly performed via femoral artery access; however, the optimal approach in extremely obese (EO) patients remains unclear. METHODS: Between January 2007 and August 2010, a cohort of consecutive EO patients who underwent coronary angiography was identified in our center's registry of angiography and percutaneous coronary intervention procedures. Of 21,103 procedures, 564 (2.7%) were performed in unique EO patients: 203 (36%) via the transradial approach; and 361 (64%) via the transfemoral approach. RESULTS: The primary outcome, a combined endpoint of major bleeding, access site complications, and nonaccess site complications, occurred in 7.5% of the transfemoral group and 2.0% of the transradial group (odds ratio [OR]: 0.30, 95% confidence interval [CI]: 0.10 to 0.88, p = 0.029), an endpoint driven by reductions in major bleeding (3.3% vs. 0.0%, OR: 0.12, 95% CI: 0 to 0.71, p = 0.015), as well as access site injuries (4.7% vs. 0.0%, OR: 0.08, 95% CI: 0 to 0.48, p = 0.002). There were no differences in nonaccess site complications (1.7% vs. 2.0%, OR: 1.50, 95% CI: 0.41 to 5.55), but transradial access procedures were associated with an increase in procedure time and patient radiation dose (p < 0.05). CONCLUSIONS: Transfemoral access for coronary angiography and percutaneous coronary intervention was associated with more bleeding and access site complications when compared with a transradial approach. Important reductions in procedural associated morbidity may be possible with a transradial approach in EO patients. |
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Authors:
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Benjamin Hibbert; Trevor Simard; Kumanan R Wilson; Steven Hawken; George A Wells; F Daniel Ramirez; Michel R Le May; Derek Y So; Chris A Glover; Michael Froeschl; Jean-Francois Marquis; Marino Labinaz; Alexander Dick; Edward R O'Brien |
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Publication Detail:
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Type: Journal Article |
Journal Detail:
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Title: JACC. Cardiovascular interventions Volume: 5 ISSN: 1876-7605 ISO Abbreviation: JACC Cardiovasc Interv Publication Date: 2012 Aug |
Date Detail:
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Created Date: 2012-08-24 Completed Date: - Revised Date: - |
Medline Journal Info:
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Nlm Unique ID: 101467004 Medline TA: JACC Cardiovasc Interv Country: United States |
Other Details:
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Languages: eng Pagination: 819-26 Citation Subset: IM |
Copyright Information:
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Copyright © 2012 American College of Cardiology Foundation. Published by Elsevier Inc. All rights reserved. |
Affiliation:
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Division of Cardiology, University of Ottawa Heart Institute, Ottawa, Ontario, Canada. |
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From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine
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