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Femoral Access PCI in a Default Radial Center Identifies High‐Risk Patients With Poor Outcomes

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Author
Uddin, Muezz
Bundhoo, Shantu
Mitra, Rito
Ossei-Gerning, Nicholas
Morris, Keith
Anderson, Richard
Kinnaird, Tim D.
Date
2015-09-24
Acceptance date
2015
Type
Article
Publisher
Hindawi
ISSN
1540-8183
Metadata
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Abstract
Background: Increasingly the trans‐radial route (TRR) is preferred over the trans‐femoral route (TFR) for PCI. However, even in high volume default TRR centers a cohort of patients undergo TFR PCI. We examined the demographics, procedural characteristics, and outcomes of patients undergoing PCI via the TF. Methods: The patient demographics, procedural data, and outcomes of 5,379 consecutive patients undergoing PCI at a default radial center between 2009 and 2012 were examined. Major bleeding (MB) was classified by ACUITY and BARC definitions. Results: A total of 559 (10.4%) patients underwent PCI via the TFR and 4,820 patients via the TRR (89.6%). Baseline variables associated with TFR were shock, previous CABG, chronic total occlusion intervention, rotablation/laser use, female sex, and renal failure. Sixty‐five patients of the TFR cohort (11.6%) experienced MB with 27 (41.5%) being access site related. MB was significantly more frequent than in the radial cohort. The variables independently associated with MB in the TFR cohort were renal failure, acute presentation, shock, and age. In the TFR, patients with MB mortality was high at 30 days (17.2% vs 2.6% for no MB, P < 0.0001) and at 1 year (37.6% vs 5.0%, P < 0.0001). Shock and MB were highly predictive of 30 day and 12 month mortality. Conclusion: In a default radial PCI center 10% of patients undergo PCI via the femoral artery. These patients have high baseline bleeding risk and undergo complex interventions. As a result the incidence of major bleeding, transfusion and death are high. Alternative strategies are required to optimize outcomes in this select group. (J Interven Cardiol 2015;28:485–492)
Journal/conference proceeding
Journal of Interventional Cardiology;
Citation
Uddin, M., Bundhoo, S., Mitra, R., Ossei‐Gerning, N., Morris, K., Anderson, R. and Kinnaird, T. (2015) 'Femoral Access PCI in a Default Radial Center Identifies High‐Risk Patients With Poor Outcomes', Journal of Interventional Cardiology, 28(5), pp.485-492. DOI: 10.1111/joic.12226.
URI
http://hdl.handle.net/10369/10816
DOI
https://doi.org/10.1111/joic.12226
Description
Article published in Journal of Interventional Cardiology on 24 September 2015, freely available at: https://doi.org/10.1111/joic.12226.
Rights
http://www.rioxx.net/licenses/all-rights-reserved
Sponsorship
Cardiff Metropolitan University (Grant ID: Cardiff Metropolian (Internal))
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  • Health and Risk Management [391]

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