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Title: Prevalence and outcomes of trans-radial access for percutaneous coronary intervention in contemporary practise
Austin Authors: Asrar Ul Haq, Muhammad;Tsay, It Meng;Dinh, Diem T;Brennan, Angela L;Clark, David J ;Cox, Nicholas;Harper, Richard;Nadurata, Voltaire;Andrianopoulos, Nick;Reid, Christopher M;Duffy, Stephen J;Lefkovits, Jeffrey;van Gaal, William J
Affiliation: Department of Cardiology, Northern Hospital, Melbourne, Victoria, Australia
Department of Medicine, The University of Melbourne, Victoria, Australia
Department of Epidemiology and Preventive Medicine, Monash University, Melbourne, Victoria, Australia
Department of Cardiology, Austin Health, Heidelberg, Victoria, Australia
Department of Medicine, Melbourne Medical School - Western Precinct, The University of Melbourne, Victoria, Australia
Cardiology Unit, Western Health, Melbourne, Victoria, Australia
Department of Cardiology, Monash Health, Melbourne, Victoria, Australia
Department of Cardiology, Bendigo Hospital, Bendigo, Victoria, Australia
Cardiology General Services, The Alfred Hospital, Melbourne, Victoria, Australia
School of Public Health, Curtin University, Perth, Western Australia, Australia
Issue Date: 15-Oct-2016
Date: 2016-06-28
Publication information: International Journal of Cardiology 2016; 221: 264-268
Abstract: BACKGROUND: Trans-radial access for percutaneous coronary intervention (PCI) has been associated with lower vascular complication rates and improved outcomes. We assessed the current uptake of trans-radial PCI in Victoria, Australia, and evaluated if patients were selected according to baseline bleeding risk in contemporary clinical practise, and compared selected clinical outcomes. METHODS: PCI data of all patients between 1st January 2013 and 31st December 2014 were analysed using The Victorian Cardiac Outcomes Registry (VCOR). Propensity-matched analysis was performed to compare the clinical outcomes. RESULTS: 11,711 procedures were analysed. The femoral route was the predominant access site (66%). Patients undergoing trans-radial access PCI were younger (63.9±11.6 vs. 67.2±11.8; p<0.001), had a higher BMI (28.9±5.5 vs. 28.5±5.2; p<0.001), more likely to be male (80.0 vs. 74.9%;p<0.001), less likely to have presented with cardiogenic shock (0.9 vs. 2.8%; p<0.001) or have the following comorbidities: diabetes (19.8 vs. 23.1%; p<0.001), peripheral vascular disease (2.9 vs. 4.3%; p=0.005) or renal impairment (13.6 vs. 22.1%; p<0.001). The radial group had less bleeding events (3.2 vs. 4.6%; p<0.001) and shorter hospital length of stay (3.1±4.7 vs. 3.3±3.9; p=0.006). There was no significant difference in mortality (1.0 vs. 1.4%; p=0.095). CONCLUSIONS: Trans-femoral approach remains the dominant access site for PCI in Victoria. The choice of route does not appear to be selected by consideration of bleeding risk. The radial route is associated with improved clinical outcomes of reduced bleeding and length of stay consistent with previous findings, and this supports the efficacy and safety of trans-radial PCI in real-world clinical practise.
DOI: 10.1016/j.ijcard.2016.06.099
Journal: International Journal of Cardiology
PubMed URL:
Type: Journal Article
Subjects: Femoral access
Percutaneous coronary intervention
Trans radial access
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