Clinical factors associated with physician choice of femoral versus radial access: A real‐world experience from a single academic center

Yee, Jimmy; Kumar, Vishesh; Li, Shenjing; Petraskova, Terezia; Pham, Alex; Stys, Julia; Thompson, Paul A.; Petrasko, Marian; Styś, Adam; Styŝ, Tomasz

doi:10.1111/joic.12479

Cited by 3 publications

(2 citation statements)

References 10 publications

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“…The same occurs in the elderly population, which also tends to benefit more from radial access due to a lower incidence of bleeding (Yee, 2018;Walter, 2017).…”

Section: Risk Factors For Post-withdrawal Complicationsmentioning

confidence: 89%

Nursing care for patients submitted to cine coronary angiography and the nurse's role in the vascular sheath removal

Leão¹,

Lima²,

Araújo³

2023

Development and Its Applications in Scientific Knowledge

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Objective: This study aims at reviewing the nursing role based on recent literature regarding patients submitted to cine coronary angiography, emphasizing arterial sheath removal procedures. Methods: This is an intuitive and narrative literature review, with a qualitative approach, using scientific articles published preferably in the last 5 years, available in full in Portuguese or English, in Scientific Electronic Library (Scielo), PubMed, and Virtual Health Library (VHL) databases. Results: Nursing professionals provide complex and essential care for the maintenance of life in patients subjected to cine coronary angiography during every moment of their hospitalization. Brazilian nurses, when trained, have the autonomy and ability to proceed with arterial sheath removal after the percutaneous endovascular procedure in the catheterization laboratory. There are new vascular closure devices that can decrease hospitalization time in femoral punction cases. However, the radial function is still associated with a lesser adverse event rate. Evidence-based practices are key in preventing iatrogenic. Final considerations: There are several ways of removing the arterial sheath and reaching hemostasis. All of them require knowledge and experience in the best ways of providing nursing care and performing techniques, aiming for the patient to have the shortest possible recovery time, without increasing the risk to which he is subjected.

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“…The same occurs in the elderly population, which also tends to benefit more from radial access due to a lower incidence of bleeding (Yee, 2018;Walter, 2017).…”

Section: Risk Factors For Post-withdrawal Complicationsmentioning

confidence: 89%

Nursing care for patients submitted to cine coronary angiography and the nurse's role in the vascular sheath removal

Leão¹,

Lima²,

Araújo³

2023

Development and Its Applications in Scientific Knowledge

View full text Add to dashboard Cite

show abstract

“…Yee et. al concluded that trans-radial access is progressively preferred as BMI increases and in younger patients, while in STEMI or emergent cases and elderly patient trans-femoral access is preferred (18).…”

Section: Discussionmentioning

confidence: 99%

Radial versus femoral access percutaneous coronary intervention in patients with acute myocardial infarction: Experience from a Southeast Asian country PCI registry

Ismail

Firdaus

Hadi

et al. 2020

Preprint

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IntroductionBleeding complications adversely affect patient’s outcomes following percutaneous coronary intervention (PCI). Radial approach PCI was advocated to overcome this complication. The information regarding the safety and feasibility of radial approach PCI in acute myocardial infarction (AMI) in the Southeast Asian population was limited. Hence, we sought to examine the outcome of radial versus femoral approach in this particular cohort.Materials and MethodsThis is an observational retrospective analysis of the Malaysian National Cardiovascular Disease Database-Percutaneous Coronary Intervention (NCVD – PCI) registry, recruiting patients with AMI from 2007 – 2014. Patients were stratified into radial and femoral groups depending on the PCI access route. The patient's baseline characteristics, lesion, and procedural data, complications, and outcomes are assessed accordingly.ResultsA total of 11,555 (4895 radial and 6660 femoral) cases were included in the analysis. In the radial group, there were predominantly more males (89.2%) with the younger patient (mean age 55.2 ± 10.5 years) as compared to the femoral group. They also had a higher body mass index (BMI) and taller. However, femoral group patients had significantly more premorbid conditions, namely diabetes mellitus, hypertension, previous stroke, heart failure, and chronic kidney disease. Complex lesions were similar in both groups with no difference in fluoroscopy time, although higher contrast load recorded in the femoral group. The adjusted odds ratio of developing in-hospital complications after femoral approach PCI compared to radial approach for death, MACE and vascular complications were OR: 8.21 95% CI 5.38 – 12.54, OR: 3.39 95% CI 2.51 – 4.58, OR: 1.79 95% CI 1.01 – 3.16 respectively. ConclusionPCI via the trans-radial approach has resulted in a significantly lower risk of vascular complications, MACE and death compared to the trans-femoral approach. Our study confirmed the superiority of the trans-radial approach in the setting of primary PCI in the Southeast Asian population and underscores the importance of trans-radial interventions to reduce bleeding complication rates.

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Feasibility and safety of transradial access for pediatric neurointerventions

Srinivasan

Hadley

Prablek

et al. 2020

J NeuroIntervent Surg

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BackgroundDiagnostic cerebral angiograms are increasingly being performed by transradial access (TRA) in adults, following data from the coronary literature supporting fewer access-site complications. Despite this ongoing trend in neuroangiography, there has been no discussion of its use in the pediatric population. Pediatric TRA has scarcely been described even for coronary or other applications. This is the first dedicated large study of transradial access for neuroangiography in pediatric patients.MethodsA multi-institutional series of consecutively performed pediatric transradial angiograms and interventions was collected. This included demographic, procedural, outcomes, and safety data. Data was prospectively recorded and retrospectively analyzed.ResultsThirty-seven diagnostic angiograms and 24 interventions were performed in 47 pediatric patients. Mean age, height, and weight was 14.1 years, 158.6 cm, and 57.1 kg, respectively. The radial artery measured 2.09+/-0.54 mm distally, and 2.09+/-0.44 mm proximally. Proximal and distal angiography were performed for both diagnostic and interventional application (17 distal angiograms, two distal interventions). Clinically significant vasospasm occurred in eight patients (13.1%). Re-access was successfully performed 11 times in seven patients. Conversion to femoral access occurred in five cases (8.2%). The only access-related complication was a small asymptomatic wrist hematoma after TR band removal.ConclusionsTransradial access in pediatric patients is safe and feasible. It can be performed successfully in many cases but carries some unique challenges compared with the adult population. Despite the challenge of higher rates of vasospasm and conversion to femoral access, it is worth exploring further, given the potential benefits.

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Clinical factors associated with physician choice of femoral versus radial access: A real‐world experience from a single academic center

Cited by 3 publications

References 10 publications

Nursing care for patients submitted to cine coronary angiography and the nurse's role in the vascular sheath removal

Nursing care for patients submitted to cine coronary angiography and the nurse's role in the vascular sheath removal

Radial versus femoral access percutaneous coronary intervention in patients with acute myocardial infarction: Experience from a Southeast Asian country PCI registry

Feasibility and safety of transradial access for pediatric neurointerventions

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