Transradial versus transfemoral ancillary approach in complex structural, coronary, and peripheral interventions. Results from the multicenter ancillary registry: A study of the Italian Radial Club

Francesco Burzotta, Carlo Trani, Antonio Colombo, Bernardo Cortese, Stefano Rigattieri, Tiziana C. Aranzulla, Filippo Russo, Azeem Latib, Pierfrancesco Agostoni, Alfonso Ielasi, Fabio Tarantino, Alessandro Sticchi, Gaetano Di Palma, Mauro De Benedictis, Roberto Boccaletti, Rosa Miccoli, Orazio Valsecchi

Risultato della ricerca: Contributo in rivistaArticolo in rivista

13 Citazioni (Scopus)

Abstract

Objectives: to understand the role of a transradial (TR) secondary approach during complex percutaneous interventions. Background: The value of the TR route for ancillary vascular approach has not been adequately validated in this setting, and there is scant data on its role in reducing bleeding complications. Methods: In the present study we retrospectively included patients undergoing the following interventions requiring two vascular approaches at nine high-volume centers in Italy: structural cardiac interventions, complex PCI, endovascular aortic repair (EVAR) and complex lower limb angioplasty. We compared procedural outcomes according to the type of ancillary vascular approach selected, namely TR or transfemoral/transbrachial (TF/TB). Primary endpoints of the study were procedural success and in-hospital BARC grade 3-5 bleedings. Results: We included 906 patients, 433 receiving TR and 473 TF/TB ancillary approaches. Baseline characteristics did not differ significantly. Patients underwent the following types of intervention: structural 50%, complex coronary PCI 37%, EVAR 11%, peripheral angioplasty 2%. Procedural success was similar (90% in TR and 92% TF/TB, P=NS). In-hospital BARC 3/5 bleedings were more common in TF/TB group as compared to TR group (19.7% vs. 6.7%,P<0.001). In TF/TB group we also observed a higher postprocedural hemoglobin drop (1.92 vs 1.13 g/dl, P=0.008) and longer hospital stay as compared to TR group. Similar results were observed in a propensity score-matched population of 450 patients. Conclusions: In our study TR ancillary approach was associated with a significant reduction in the risk of major bleedings, without jeopardizing the success of complex structural, coronary, and peripheral percutaneous interventions. The value of the transradial route for ancillary vascular approach during percutaneous interventions has not been adequately validated yet. We retrospectively included 906 patients, 433 receiving TR and 473 TF/TB ancillary approach at nine high-volume centers for the following interventions: structural cardiac interventions, complex PCI, EVAR and complex peripheral angioplasty. Procedural success was similar, whereas in-hospital BARC bleedings were more common in the transfemoral/brachial group. Similar results were observed in a propensity score-matched population. In our study TR ancillary approach was associated with a significant reduction in the risk of major bleedings, without jeopardizing the success of complex interventions.
Lingua originaleEnglish
pagine (da-a)97-102
Numero di pagine6
RivistaCatheterization and Cardiovascular Interventions
Volume91
DOI
Stato di pubblicazionePubblicato - 2017

Keywords

  • Ancillary approach
  • Bleedings
  • Cardiology and Cardiovascular Medicine
  • Radiology, Nuclear Medicine and Imaging
  • Secondary approach
  • TAVI

Fingerprint Entra nei temi di ricerca di 'Transradial versus transfemoral ancillary approach in complex structural, coronary, and peripheral interventions. Results from the multicenter ancillary registry: A study of the Italian Radial Club'. Insieme formano una fingerprint unica.

Cita questo