Transradial vs. Transfemoral Percutaneous Coronary Intervention in Patients With or Without High Bleeding Risk Criteria

Yamamoto, Ko; Natsuaki, Masahiro; Morimoto, Takeshi; Shiomi, Hiroki; Watanabe, Hirotoshi; Yamaji, Kyohei; Watanabe, Hiroki; Kato, Takao; Saito, Naritatsu; Ando, Kenji; Kadota, Kazushige; Furukawa, Yutaka; Kimura, Takeshi

doi:10.1253/circj.cj-19-1117

Cited by 9 publications

(6 citation statements)

References 34 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…2). We referred to a previous study that modified the HBR criteria [5], and classified patients who met 1 item from the major criteria or 2 items from the minor criteria into the HBR group. In the PCI procedure, success was defined by the guidewire passing through the lesion with the coronary artery opened by balloon dilation or stent placement [6].…”

Section: Definitionsmentioning

confidence: 99%

Relationship between in-hospital event rates and high bleeding risk score in patients undergoing primary percutaneous coronary intervention for acute myocardial infarction

Tsukizawa

Fujihara

2021

Cardiovasc Interv and Ther

View full text Add to dashboard Cite

Academic Research Consortium for High Bleeding Risk (ARC-HBR) was defined as a criterion for predicting the risk of bleeding in patients who undergo percutaneous coronary intervention (PCI). Major bleeding is related to in-hospital mortality. However, few studies examining the HBR criteria in patients with acute myocardial infarction (AMI) have been reported. We analyzed the relationship between HBR criteria in AMI patients and in-hospital events. This study was a single-center retrospective study that included 781 patients who underwent PCI for ST-elevation myocardial infarction (STEMI) and non-ST-elevation myocardial infarction (NSTEMI) from January 2010 to December 2018. Patients were classified into the HBR group (n = 309, 39.6%) and non-HBR group (n = 472, 60.4%) and investigated. The primary endpoint was the incidence of in-hospital mortality, major bleeding, recurrent MI, and stroke. As a secondary endpoint, a multivariate analysis of cases of in-hospital death was performed to identify predictors of in-hospital mortality. As the primary outcome, the rate of all events in the HBR group was significantly higher than that in the non-HBR group (29.1% vs. 11.2%, p < 0.001). Among the individual events, the rates of major bleeding (11.3% vs. 3.8%, p < 0.001) and in-hospital mortality (16.2% vs. 4.2%, p < 0.001) were significantly higher in the HBR group. Regarding the secondary outcome, the overall in-hospital mortality rate was 9.0%. The multivariate analysis revealed that ejection fraction < 40%, HBR, Killip 4, and left main trunk lesion were significant predictors of in-hospital mortality. In conclusion, the HBR criteria were associated with in-hospital events in AMI patients who underwent primary PCI.

show abstract

Section: Definitionsmentioning

confidence: 99%

Relationship between in-hospital event rates and high bleeding risk score in patients undergoing primary percutaneous coronary intervention for acute myocardial infarction

Tsukizawa

Fujihara

2021

Cardiovasc Interv and Ther

View full text Add to dashboard Cite

show abstract

“…The main limitation is the missing information on the secondary endpoints bleeding and AKI after PCI in the swPCI group. According to recent publications, rates of puncture site bleeding after PCI range between 0.5% and 3% 37,38 . Rates of AKI range around 4%, as recently found in a large registry 39 .…”

Section: Discussionmentioning

confidence: 80%

Concomitant percutaneous coronary intervention in patients undergoing transcatheter aortic valve implantation

Fischer,

Steffen,

Arlart

et al. 2023

Cathet Cardio Intervent

View full text Add to dashboard Cite

BackgroundPatients undergoing transcatheter aortic valve implantation (TAVI) frequently have coronary artery disease requiring percutaneous coronary intervention (PCI). Usually, PCI and TAVI are performed in two separate procedures and current studies are investigating potential benefits regarding the order. However, the two interventions may also be performed simultaneously, thereby limiting the risk associated with repeated vascular access. Data evaluating benefit and harm of concomitant procedures are scarce.AimsTherefore, this study aimed to evaluate concomitant PCI (coPCI) in TAVI patients regarding Valve Academic Research Consortium 3 (VARC‐3) endpoints and long‐term mortality.MethodsA total of 2233 consecutive TAVI patients from the EVERY‐VALVE registry were analyzed according to the VARC‐3 endpoint definitions. A total of 274 patients had undergone TAVI and concomitant PCI (coPCI group). They were compared to 226 TAVI patients who had received PCI within 60 days before TAVI in a stepwise approach (swPCI group) and to the remaining 1733 TAVI patients who had not undergone PCI recently (noPCI group).ResultsOverall median age was 81.4 years, median Society of Thoracic Surgeons score was 4.0%. Patients in the coPCI and in the swPCI group were predominantly male with reduced left‐ventricular ejection fraction. Rates of VARC‐3 composite endpoints technical success and 30‐day device success were comparable between all three groups. Mortality rates at 3 years after TAVI were similar (coPCI, 34.2% vs. swPCI, 31.9% vs. noPCI, 34.0% p = 0.84).ConclusionscoPCI during TAVI seems comparable in a retrospective analysis. Compared to a stepwise approach, it has similar rates of composite endpoints technical success and device success as well as long‐term mortality.

show abstract

“…The trans-radial approach (TRA) was established over the past three decades. It is now widely accepted in many situations as the standard access for invasive coronary catheter procedures [1][2][3][4][5][6]. Since the radial arteries are located superficially in the forearm, access is easy, and the method is safe.…”

Section: Introductionmentioning

confidence: 99%

Impact of radial compression protocols on radial artery occlusion and hemostasis time in coronary angiography

Takamatsu

Kagiyama

Sone³

et al. 2022

Cardiovasc Interv and Ther

View full text Add to dashboard Cite

Protocols for hemostasis after trans-radial approach (TRA) vary depending on the institute as there is no established evidence-based protocol. This study aimed to investigate the clinical implications of radial compression protocols. Consecutive patients who underwent outpatient invasive catheter angiography before and after April 2018 were treated with traditional and new protocols, respectively. Using the same hemostasis band, in the conventional protocol, fixed amount of air was removed soon after the procedure, 2 h later, and 3 h later, whereas the air was removed as much as possible every 30 min in the new protocol. A total of 1842 patients (71 ± 10 years old, 77% male) were included. Compared with the traditional protocol group (n = 1001), the new protocol group (n = 841) had a significantly lower rate of dual antiplatelet therapy (35% and 24% in the traditional and new groups, respectively, p < 0.001). The time required for complete hemostasis was approximately one-third with the new protocol (190 ± 16 and 66 ± 32 min, p < 0.001) with no clinically relevant bleeding. The incidence of radial artery occlusion (RAO) was 9.8% and 0.9% in the traditional and new protocol groups, respectively (p < 0.001). After adjusting for covariates, the new protocol was associated with a reduced risk of RAO (odds ratio 0.10, p < 0.001) and a shorter hemostasis time (odds ratio 0.01, p < 0.001). The new protocol for hemostasis after TRA was strongly associated with a shorter hemostasis time and a lower rate of RAO.

show abstract

Transradial vs. Transfemoral Percutaneous Coronary Intervention in Patients With or Without High Bleeding Risk Criteria

Cited by 9 publications

References 34 publications

Relationship between in-hospital event rates and high bleeding risk score in patients undergoing primary percutaneous coronary intervention for acute myocardial infarction

Relationship between in-hospital event rates and high bleeding risk score in patients undergoing primary percutaneous coronary intervention for acute myocardial infarction

Concomitant percutaneous coronary intervention in patients undergoing transcatheter aortic valve implantation

Impact of radial compression protocols on radial artery occlusion and hemostasis time in coronary angiography

Contact Info

Product

Resources

About