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

• 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.

Ämnesord

MEDICIN OCH HÄLSOVETENSKAP  -- Klinisk medicin -- Dermatologi och venereologi (hsv//swe)

MEDICAL AND HEALTH SCIENCES  -- Clinical Medicine -- Dermatology and Venereal Diseases (hsv//eng)

MEDICIN OCH HÄLSOVETENSKAP  -- Klinisk medicin -- Anestesi och intensivvård (hsv//swe)

MEDICAL AND HEALTH SCIENCES  -- Clinical Medicine -- Anesthesiology and Intensive Care (hsv//eng)

MEDICIN OCH HÄLSOVETENSKAP  -- Klinisk medicin -- Kardiologi (hsv//swe)

MEDICAL AND HEALTH SCIENCES  -- Clinical Medicine -- Cardiac and Cardiovascular Systems (hsv//eng)

Nyckelord

Age Factors

Aged

80 and over

Angioplasty

Transluminal

Percutaneous Coronary

adverse effects

methods

mortality

Biological Markers

blood

Cerebrovascular Disorders

etiology

Coronary Angiography

Coronary Artery Disease

mortality

radiography

therapy

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

Aged, 80 and over

Angioplasty, Balloon, Coronary/adverse effects

Biomarkers/blood

Cerebrovascular Disorders/etiology

Coronary Artery Disease/diagnostic imaging

Creatinine/blood

Hemorrhage/etiology

Publikations- och innehållstyp

ref (ämneskategori)

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