Transradial Approach for Noncoronary Interventions: A Single-Center Review of Safety and Feasibility in the First 1,500 Cases
| Autor: | N. Tabori, F. Scott Nowakowski, D. Biederman, Edward Kim, Raghuram Posham, Aaron M. Fischman, Rahul S. Patel, Robert A. Lookstein |
|---|---|
| Rok vydání: | 2016 |
| Předmět: |
medicine.medical_specialty
Univariate analysis business.industry Hazard ratio Retrospective cohort study 030204 cardiovascular system & hematology medicine.disease Single Center Confidence interval 030218 nuclear medicine & medical imaging Surgery 03 medical and health sciences Pseudoaneurysm 0302 clinical medicine Hematoma medicine.artery medicine Radiology Nuclear Medicine and imaging Radial artery Cardiology and Cardiovascular Medicine business |
| Zdroj: | Journal of Vascular and Interventional Radiology. 27:159-166 |
| ISSN: | 1051-0443 |
| Popis: | Purpose To review safety and feasibility in a single center using transradial access (TRA) for noncoronary interventions. Materials and Methods Retrospective analysis was performed of 946 patients evaluated for 1,531 consecutive TRA procedures from April 2012 to July 2015. Exclusion criteria included sheath > 6 F, Barbeau D waveform, radial artery (RA) diameter Results Technical success was 98.2% (1,485/1,512). Major complications (0.13%) included pseudoaneurysm (n = 1) and seizure (n = 1). Minor complications (2.38%) included hematoma/bleeding (n = 13), RA occlusion (n = 11), arm pain (n = 6), and RA spasm (n = 6). Univariate analysis demonstrated a lower rate of adverse events in African American patients (hazard ratio [HR], 0.25; 95% confidence interval [CI], 0.07–0.86; P = .027). Twenty-seven cases (1.8%) required crossover to transfemoral access (TFA). Crossover rates were higher in female patients ( P = .0055), height P = .024), renal/visceral interventions ( P = .0003), and endoleak interventions ( P = .0357). Multivariate analysis demonstrated intervention type to be the only significant predictor of TFA crossover (renal/visceral [HR, 4.48; 95% CI, 1.84–10.9; P = .001]; endoleak repair [HR, 9.54; 95% CI, 1.09–83.8; P = .042]). Conclusions TRA was safe and well tolerated in a heterogeneous patient population across a range of peripheral vascular interventions. |
| Databáze: | OpenAIRE |
| Externí odkaz: |
|