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  • Desta, LiyewKarolinska Institutet,Division of Cardiology, Department of Medicine, Karolinska Institute Huddinge and Karolinska University Hospital, Stockholm, Sweden (author)

Transradial versus trans-femoral access site in high-speed rotational atherectomy in Sweden

  • Article/chapterEnglish2022

Publisher, publication year, extent ...

  • Elsevier BV,2022
  • 7 s.

Numbers

  • LIBRIS-ID:oai:lup.lub.lu.se:deeed8a5-91cf-495f-b1e4-35d7216d646f
  • https://lup.lub.lu.se/record/deeed8a5-91cf-495f-b1e4-35d7216d646fURI
  • https://doi.org/10.1016/j.ijcard.2022.01.039DOI
  • http://kipublications.ki.se/Default.aspx?queryparsed=id:149593407URI
  • https://urn.kb.se/resolve?urn=urn:nbn:se:liu:diva-193354URI
  • https://gup.ub.gu.se/publication/313208URI

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  • Language:English
  • Summary in:English

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  • Subject category:art swepub-publicationtype
  • Subject category:ref swepub-contenttype

Notes

  • Background: Radial artery is the preferred access site in contemporary percutaneous coronary intervention (PCI). However, limited data exist regarding utilization pattern, safety, and long-term efficacy of transradial artery access (TRA) PCI in heavily calcified lesions using high-speed rotational atherectomy (HSRA). Methods: All patients who underwent HSRA-PCI in Sweden between 2005 and 2016 were included. Outcomes were major adverse cardiac events (MACE, including death, myocardial infarction (MI) or target vessel revascularisation (TVR)), in-hospital bleeding and restenosis. Inverse probability of treatment weighting was used to adjust for the non-randomized access site selection. Results: We included 1479 patients of whom 649 had TRA and 782 transfemoral artery access (TFA) HSRA-PCI. The rate of TRA increased significantly by 18% per year but remained lower in HSRA-PCI (60%) than in the overall PCI population (85%) in 2016. TRA was associated with comparable angiographic success but significantly lower risk for major (adjusted OR 0.16; 95% CI 0.05–0.47) or any in-hospital bleeding (adjusted OR 0.32; 95% CI 0.13–0.78). At one year, the adjusted risk for MACE (HR 0.87; 95% CI 0.67–1.13) and its individual components did not differ between TRA and TFA patients. The risk for restenosis did not significantly differ between TRA and TFA HSRA-PCI treated lesions (adjusted HR 0.92; 95% CI 0.46–1.81). Conclusion: HSRA-PCI by TRA was associated with significantly lower risk for in-hospital bleeding and equivalent long-term efficacy when compared with TFA. Our data support the feasibility and superior safety profile of TRA in HSRA-PCI.

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  • Jurga, JulianeKarolinska Institutet,Division of Cardiology, Department of Medicine, Karolinska Institute Solna and Karolinska University Hospital, Stockholm, Sweden (author)
  • Völz, Sebastian,1980Gothenburg University,Göteborgs universitet,Institutionen för medicin, avdelningen för molekylär och klinisk medicin,Institute of Medicine, Department of Molecular and Clinical Medicine(Swepub:gu)xvolse (author)
  • Omerovic, Elmir,1968Gothenburg University,Göteborgs universitet,Institutionen för medicin, avdelningen för molekylär och klinisk medicin,Institute of Medicine, Department of Molecular and Clinical Medicine(Swepub:gu)xomeel (author)
  • Ulvenstam, AndersDepartment of Internal Medicine and Cardiology, Östersund Hospital, Östersund, Sweden (author)
  • Zwackman, SammyLinköpings universitet,Linköping University,Avdelningen för diagnostik och specialistmedicin,Medicinska fakulteten,Region Östergötland, Kardiologiska kliniken US(Swepub:liu)samzw44 (author)
  • Pagonis, ChristosLinköpings universitet,Linköping University,Avdelningen för diagnostik och specialistmedicin,Medicinska fakulteten,Region Östergötland, Kardiologiska kliniken US(Swepub:liu)chrpa43 (author)
  • Calle, FredrikÖrebro University,Örebro University, Faculty of Health, Department of Cardiology, Örebro, Sweden (author)
  • Olivecrona, Göran K.Lund University,Lunds universitet,Kardiologi,Sektion II,Institutionen för kliniska vetenskaper, Lund,Medicinska fakulteten,Cardiology,Section II,Department of Clinical Sciences, Lund,Faculty of Medicine,Department of Cardiology, Lund University and HSkåne University Hospital, Lund, Sweden(Swepub:lu)kard-gol (author)
  • Persson, JonasDepartment of Clinical sciences, Danderyd Hospital, Karolinska Institute, Stockholm, Sweden (author)
  • Venetsanos, DimitriosDivision of Cardiology, Department of Medicine, Karolinska Institute Solna and Karolinska University Hospital, Stockholm, Sweden (author)
  • Karolinska InstitutetDivision of Cardiology, Department of Medicine, Karolinska Institute Huddinge and Karolinska University Hospital, Stockholm, Sweden (creator_code:org_t)

Related titles

  • In:International Journal of Cardiology: Elsevier BV352, s. 45-510167-52731874-1754

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