Radial Versus Femoral Approach for Percutaneous Coronary Intervention : MACE Outcomes at Long-Term Follow-up
Articolo
Data di Pubblicazione:
2018
Citazione:
Radial Versus Femoral Approach for Percutaneous Coronary Intervention : MACE Outcomes at Long-Term Follow-up / F. Campelo-Parada, D. Carrié, A.L. Bartorelli, A. Namiki, T. Hovasse, T. Kimura, A. Serra-Peñaranda, O. Varenne, J. Lalmand, K. Kadota, Y. Ikari, T. Tobaru, K. Fujii, S. Nakamura, S. Saito, W. Wijns. - In: JOURNAL OF INVASIVE CARDIOLOGY. - ISSN 1042-3931. - 30:7(2018), pp. 262-268.
Abstract:
Objective: To compare the main outcomes of radial versus femoral access at long-term follow-up. Background: Little is known about the long-term major cardiovascular events and bleeding complications of patients undergoing percutaneous coronary intervention (PCI) with radial vs femoral approach. Methods: A total of 1107 patients from the CENTURY II trial were included. To minimize baseline differences between radial and femoral groups, we applied propensity-score matching for this comparison. Results: In this multicenter study, the radial approach was used in 73.4% of patients. After propensity-score matching, baseline and procedural characteristics were comparable between both groups. Procedural success was high and similar in radial and femoral approaches (98.2% vs 97.5%; P=.47) while radial access was associated with a shorter hospital stay (1.69 ± 1.92 days vs 2.08 ± 1.98 days; P<.01). The short-term bleeding and vascular complication rates were significantly lower in the radial group (1.7% vs 6.2% [P<.001 in-hospital] and 2.7% vs 9.6% [P<.001 at 1-month follow-up]). At 3-year follow-up, radial access was associated with lower rates of all-cause mortality (3.9 vs 6.9%; P=.04) and cardiovascular death (2.1 vs 4.9%; P=.02). The composite of all-cause mortality, myocardial infarction, and revascularization showed no differences between groups (18.2 vs 21.1%; P=.29). Conclusions: Compared to the femoral approach, the radial approach is associated with significantly lower long-term all-cause mortality rate as well as lower in-hospital and short-term bleeding rates. These results suggest additional long-term benefits of radial access for PCI, but should be interpreted within the context of the current study and further verified in future studies.
Tipologia IRIS:
01 - Articolo su periodico
Keywords:
access site; radial vs femoral; Radiology, Nuclear Medicine and Imaging; Cardiology and Cardiovascular Medicine
Elenco autori:
F. Campelo-Parada, D. Carrié, A.L. Bartorelli, A. Namiki, T. Hovasse, T. Kimura, A. Serra-Peñaranda, O. Varenne, J. Lalmand, K. Kadota, Y. Ikari, T. Tobaru, K. Fujii, S. Nakamura, S. Saito, W. Wijns
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