PMID- 25312663
OWN - NLM
STAT- MEDLINE
DCOM- 20150901
LR  - 20181202
IS  - 0376-2491 (Print)
IS  - 0376-2491 (Linking)
VI  - 94
IP  - 26
DP  - 2014 Jul 8
TI  - [Comparison of radial versus femoral approach for percutaneous coronary 
      intervention in octogenarians with acute coronary syndrome].
PG  - 2025-9
AB  - OBJECTIVE: To evaluate the prognostic effects of radial artery access (RA) versus 
      femoral artery access (FA) in octogenarians undergoing percutaneous coronary 
      intervention (PCI) due to acute coronary syndrome (ACS). METHODS: From January 
      2008 to January 2013, 279 octogenarians with ACS underwent PCI. PCI was performed 
      through RA in 125 patients and FA in another 154. Clinical and procedural 
      characteristics, combined endpoints including death, acute myocardial infarction, 
      stroke, and major bleeding, and peripheral vascular complications were obtained 
      from both groups. RESULTS: The clinical baseline characteristics of two patient 
      groups, including target vessel location, lesion type, number of implanted 
      stents, fluoroscopy duration and utilization of contrast media had no statistical 
      difference.Femoral approach was associated with a higher rate of ST elevation 
      myocardial infarction (STEMI) than radial approach (27.9% vs 11.2%, chi(2) = 11.868, 
      P < 0.05). Procedural rate of success, fluoroscopy duration and utilization of 
      contrast media were equivalent with both approaches. Radial approach was 
      associated with a higher crossover rate (10.4% vs 3.9%, chi(2) = 4.599, P < 0.05) to 
      alternate access site compared with the femoral approach.No difference in 
      combined endpoint during 30 days after PCI including death, acute myocardial 
      infarction, stroke and major bleeding was found between two groups (P > 
      0.05).However, ambulation time (4.2 +/- 0.9 vs 19.3 +/- 4.1h, t = 40.381, P < 0.01), 
      incidence of access site bleeding (2.4% vs 7.8%, chi(2) = 3.943, P < 0.05), hematoma 
      (2.4% vs 9.1%, chi(2) = 5.398, P < 0.05), pseudoaneurysm (0.0% vs 5.2%, chi(2) = 4.950, P 
      < 0.05) and vascular complications (4.8% vs 19.5%, chi(2) = 13.231, P < 0.01) were 
      significantly lowered in radial approach group. Multivariate regression analysis 
      identified radial approach as an independent negative predictor of postprocedural 
      vascular complications (OR = 0.329, 95% CI: 0.124-0.517, P < 0.05).Female gender 
      (OR = 1.955, 95% CI: 1.326-2.248, P < 0.05) and utilization of glycoprotein 
      IIb/IIIa receptor antagonist (OR = 2.787, 95% CI: 2.435-3.071, P < 0.01) were 
      independent predictors of postprocedural vascular complications. CONCLUSIONS: 
      Compared with femoral approach, radial approach significantly reduces the 
      vascular complications of PCI in octogenarians with ACS.However, PCI through RA 
      is not associated with reduced combined endpoint at 30 days in octogerians with 
      ACS.
FAU - Gao, Lei
AU  - Gao L
AD  - Institute of Geriatric Cardiology, PLA General Hospital, Beijing 100853, China. 
      Email: nkgaolei2010@126.com.
FAU - Liu, Yuqi
AU  - Liu Y
AD  - Institute of Geriatric Cardiology, PLA General Hospital, Beijing 100853, China.
FAU - Xue, Qiao
AU  - Xue Q
AD  - Institute of Geriatric Cardiology, PLA General Hospital, Beijing 100853, China.
FAU - Tian, Jinwen
AU  - Tian J
AD  - Institute of Geriatric Cardiology, PLA General Hospital, Beijing 100853, China.
FAU - Wang, Yu
AU  - Wang Y
AD  - Institute of Geriatric Cardiology, PLA General Hospital, Beijing 100853, China.
LA  - chi
PT  - Comparative Study
PT  - Journal Article
PL  - China
TA  - Zhonghua Yi Xue Za Zhi
JT  - Zhonghua yi xue za zhi
JID - 7511141
RN  - 0 (Contrast Media)
RN  - 0 (Platelet Aggregation Inhibitors)
SB  - IM
MH  - Acute Coronary Syndrome/*therapy
MH  - Contrast Media
MH  - Female
MH  - *Femoral Artery
MH  - Fluoroscopy
MH  - Hematoma
MH  - Hemorrhage
MH  - Humans
MH  - Male
MH  - Percutaneous Coronary Intervention/*methods
MH  - Platelet Aggregation Inhibitors
MH  - *Radial Artery
MH  - Treatment Outcome
EDAT- 2014/10/15 06:00
MHDA- 2015/09/02 06:00
CRDT- 2014/10/15 06:00
PHST- 2014/10/15 06:00 [entrez]
PHST- 2014/10/15 06:00 [pubmed]
PHST- 2015/09/02 06:00 [medline]
PST - ppublish
SO  - Zhonghua Yi Xue Za Zhi. 2014 Jul 8;94(26):2025-9.