echanism and Predictors of ailed Transradial Approach for ercutaneous Coronary Interventions

esults A total of 2,100 patients underwent TR-PCI and represented 38% of PCI volume. Mean age as 64 12 years, and 17% were female. Vascular complications occurred in 22 (1%), and TR-PCI ailure was observed in 98 (4.7%) patients. The mechanism of TR-PCI failure included inability to adance guide catheter to ascending aorta in 50 (51%), inadequate guide catheter support in 35 36%), and unsuccessful radial artery puncture in 13 (13%) patients. The PCI was successful in 94 96%) patients with TR-PCI failure by switching to TF. On multivariate analysis, age 75 years (odds atio [OR]: 3.86; 95% confidence interval [CI]: 2.33 to 6.40, p 0.0006), prior coronary artery bypass raft surgery (OR: 7.47; 95% CI: 3.45 to 16.19, p 0.0002), and height (OR: 0.97; 95% CI: 0.95 to .99, p 0.02) were independent predictors of TR-PCI failure.

[1]  E. Vicaut,et al.  Predictors of outcome in patients undergoing PCI. Results of the RIVIERA study. , 2008, International journal of cardiology.

[2]  Fang-Shu Ou,et al.  Trends in the prevalence and outcomes of radial and femoral approaches to percutaneous coronary intervention: a report from the National Cardiovascular Data Registry. , 2008, JACC. Cardiovascular interventions.

[3]  B. Gersh,et al.  Bivalirudin during primary PCI in acute myocardial infarction. , 2008, The New England journal of medicine.

[4]  J D Hilton,et al.  Association of the arterial access site at angioplasty with transfusion and mortality: the M.O.R.T.A.L study (Mortality benefit Of Reduced Transfusion after percutaneous coronary intervention via the Arm or Leg) , 2008, Heart.

[5]  A. Jacobs,et al.  Access site hematoma requiring blood transfusion predicts mortality in patients undergoing percutaneous coronary intervention: Data from the National Heart, Lung, and Blood Institute Dynamic Registry , 2007, Catheterization and cardiovascular interventions : official journal of the Society for Cardiac Angiography & Interventions.

[6]  R. Jaffe,et al.  Comparison of radial versus femoral approach for percutaneous coronary interventions in octogenarians , 2007, Catheterization and cardiovascular interventions : official journal of the Society for Cardiac Angiography & Interventions.

[7]  H. White,et al.  Impact of major bleeding on 30-day mortality and clinical outcomes in patients with acute coronary syndromes: an analysis from the ACUITY Trial. , 2007, Journal of the American College of Cardiology.

[8]  R. Califf,et al.  Bleeding complications in patients with acute coronary syndrome undergoing early invasive management can be reduced with radial access, smaller sheath sizes, and timely sheath removal , 2007, Catheterization and cardiovascular interventions : official journal of the Society for Cardiac Angiography & Interventions.

[9]  P. Poirier,et al.  A Randomized Study Comparing Same-Day Home Discharge and Abciximab Bolus Only to Overnight Hospitalization and Abciximab Bolus and Infusion After Transradial Coronary Stent Implantation , 2006, Circulation.

[10]  D. Roberts,et al.  Day case transradial coronary angioplasty: A four‐year single‐center experience , 2006, Catheterization and cardiovascular interventions : official journal of the Society for Cardiac Angiography & Interventions.

[11]  S. Yusuf,et al.  Adverse Impact of Bleeding on Prognosis in Patients With Acute Coronary Syndromes , 2006, Circulation.

[12]  M. Hamon.  Vascular access site complications after PCI: current status and future directions , 2006, Nature Clinical Practice Cardiovascular Medicine.

[13]  A. Gavazzi,et al.  Failure of transradial approach during coronary interventions: Anatomic considerations , 2006, Catheterization and cardiovascular interventions : official journal of the Society for Cardiac Angiography & Interventions.

[14]  Salim Yusuf,et al.  Comparison of fondaparinux and enoxaparin in acute coronary syndromes. , 2006, The New England journal of medicine.

[15]  R. Califf,et al.  Impact of bleeding severity on clinical outcomes among patients with acute coronary syndromes. , 2005, The American journal of cardiology.

[16]  J. Baz,et al.  Safety and efficacy of a multipurpose coronary angiography strategy using the transradial technique. , 2005, The Journal of invasive cardiology.

[17]  P. Garot,et al.  Comparison of transradial and transfemoral approaches for coronary angiography and angioplasty in octogenarians (the OCTOPLUS study). , 2004, The American journal of cardiology.

[18]  D. Patel,et al.  Radial versus femoral access for rescue percutaneous coronary intervention with adjuvant glycoprotein IIb/IIIa inhibitor use. , 2004, The Canadian journal of cardiology.

[19]  G. Biondi-Zoccai,et al.  Radial versus femoral approach for percutaneous coronary diagnostic and interventional procedures; Systematic overview and meta-analysis of randomized trials. , 2004, Journal of the American College of Cardiology.

[20]  K. Cha,et al.  Prevalence and clinical predictors of severe tortuosity of right subclavian artery in patients undergoing transradial coronary angiography. , 2003, The American journal of cardiology.

[21]  N. Weissman,et al.  Incidence, predictors, and prognostic implications of bleeding and blood transfusion following percutaneous coronary interventions. , 2003, The American journal of cardiology.

[22]  T. Ryan,et al.  Predicting vascular complications in percutaneous coronary interventions. , 2003, American heart journal.

[23]  G. Laarman,et al.  Evaluation of a spasmolytic cocktail to prevent radial artery spasm during coronary procedures , 2003, Catheterization and cardiovascular interventions : official journal of the Society for Cardiac Angiography & Interventions.

[24]  H. Völzke,et al.  A randomized trial of 5 vs. 6 French transradial percutaneous coronary interventions , 2002, Catheterization and cardiovascular interventions : official journal of the Society for Cardiac Angiography & Interventions.

[25]  P. Esente,et al.  Overcoming vascular anatomic challenges to cardiac catheterization by the radial artery approach: Specific techniques to improve success , 2002, Catheterization and cardiovascular interventions : official journal of the Society for Cardiac Angiography & Interventions.

[26]  S. Takeshita,et al.  Efficacy of transradial primary stenting in patients with acute myocardial infarction. , 1999, The American journal of cardiology.

[27]  J. Schneider,et al.  Stenting in acute coronary syndromes: a comparison of radial versus femoral access sites. , 1998, Journal of the American College of Cardiology.

[28]  S. Goldberg,et al.  Learning curve in the use of the radial artery as vascular access in the performance of percutaneous transluminal coronary angioplasty. , 1998, Catheterization and cardiovascular diagnosis.

[29]  K. Kadota,et al.  New guiding catheter for transrad PTCA. , 1998, Catheterization and cardiovascular diagnosis.

[30]  G. Laarman,et al.  A randomized comparison of percutaneous transluminal coronary angioplasty by the radial, brachial and femoral approaches: the access study. , 1997, Journal of the American College of Cardiology.

[31]  J. Hofland,et al.  Cost comparison between two modes of Palmaz Schatz coronary stent implantation: transradial bare stent technique vs. transfemoral sheath-protected stent technique. , 1995, Catheterization and cardiovascular diagnosis.

[32]  Salim Yusuf,et al.  Radial versus femoral access for coronary angiography or intervention and the impact on major bleeding and ischemic events: a systematic review and meta-analysis of randomized trials. , 2009, American heart journal.

[33]  A. Jaffe,et al.  Thrombolysis in Myocardial Infarction (TIMI) Trial--phase I: hemorrhagic manifestations and changes in plasma fibrinogen and the fibrinolytic system in patients treated with recombinant tissue plasminogen activator and streptokinase. , 1988, Journal of the American College of Cardiology.