Radial vs. femoral approach for primary percutaneous coronary intervention in octogenarians

Michael Koutouzis, Göran Matejka, Göran Olivecrona, Lars Grip, Per Albertsson

Research output: Contribution to journalArticlepeer-review

Abstract

BACKGROUND: The transradial approach is associated with fewer bleeding complications during percutaneous coronary interventions (PCIs) but is more technically challenging and associated with prolonged times during intervention. The aim of this study is to retrospectively compare the results of radial vs. femoral approach in patients >or=80 years old undergoing primary or rescue PCI.METHODS: Between January 2002 and December 2007, 354 interventions were performed in our institution with the indication of primary or rescue PCI in patients over 80 years old, without history of previous bypass operation or cardiogenic shock on presentation. Thirteen patients required a change of the approach during the procedure and were not enrolled in the final analysis. Forty (12%) interventions were performed through the transradial approach and 301 (88%) through the femoral approach. In-hospital major adverse cerebral and cardiac events and access site bleeding complications as well as 30- and 365-day mortality, procedural times, and contrast volume were evaluated.

RESULTS: The two groups had similar clinical characteristics, with the exception of serum creatinine that was higher in the transfemoral approach group. There were no differences in procedural times and clinical outcomes, although the transfemoral group had numerically more access site bleeding complications (12/301 vs. 0/40, P=.41). The transradial approach had a higher conversion rate compared with the transfemoral approach (18.3% vs. 1.3%, P<.001).

CONCLUSION: The transradial approach is feasible and safe in the octogenarians undergoing primary and rescue PCI, but it is associated with a high conversion rate to another approach.

Original languageEnglish
Pages (from-to)79-83
Number of pages5
JournalCardiovascular Revascularization Medicine
Volume11
Issue number2
DOIs
Publication statusPublished - 2010 Mar 30

Subject classification (UKÄ)

  • Medical and Health Sciences
  • Anesthesiology and Intensive Care
  • Cardiac and Cardiovascular Systems

Free keywords

  • Age Factors
  • Aged, 80 and over
  • Angioplasty, Balloon, Coronary/adverse effects
  • Biomarkers/blood
  • Cerebrovascular Disorders/etiology
  • Coronary Angiography
  • Coronary Artery Disease/diagnostic imaging
  • Creatinine/blood
  • Feasibility Studies
  • Female
  • Femoral Artery
  • Hemorrhage/etiology
  • Hospital Mortality
  • Humans
  • Male
  • Radial Artery
  • Retrospective Studies
  • Risk Assessment
  • Risk Factors
  • Severity of Illness Index
  • Time Factors
  • Treatment Outcome

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