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Article: Predictors of Access Site Crossover in Patients Who Underwent Transradial Coronary Angiography

TitlePredictors of Access Site Crossover in Patients Who Underwent Transradial Coronary Angiography
Authors
Issue Date2015
Citation
American Journal of Cardiology, 2015, v. 116, n. 3, p. 379-383 How to Cite?
AbstractDespite increasing use of the transradial approach (TRA) for coronary angiography, TRA failure and subsequent access site crossover remain a barrier to TRA adoption. The aim of this study was to elucidate patient and procedural characteristics associated with TRA to transfemoral approach (TFA) crossover and examine TRA to TFA crossover by operator experience over time. This retrospective analysis identified 1,600 patients who underwent coronary angiography with possible percutaneous coronary intervention through TRA by operators with varied TRA experience in an urban tertiary care center from October 2010 to August 2013. Univariate and multivariable logistic regression were used to identify independent predictors of access site crossover, from TRA to TFA, and strength of association is presented as odds ratio (OR, 95% confidence interval [CI]). Access site crossover was noted in 166 patients (10.4%). Multivariable predictors of access site crossover included age >75 years (OR 1.90, 95% CI 1.23 to 2.91, p = 0.004) and operator experience (OR 2.98, 95% CI 1.96 to 4.52, p <0.0001). Less experienced operators (≤5 years TRA experience) had a decrease in access site crossover over time (quartile 1: 8.9%, quartile 2: 18.8%, quartile 3: 16.4%, and quartile 4: 8.6%, p <0.001), which paralleled an increase in the proportion of procedures using initial TRA over time (quartile 1: 38.0%, quartile 2: 53.7%, quartile 3: 54.8%, and quartile 4: 70.3%, p <0.001). Experienced operators (;gt;5 years TRA experience) had no significant change in proportion of access site crossover over time (quartile 1: 2.8%, quartile 2: 6.4%, quartile 3: 5.6%, quartile 4: 5.8%, p = 0.54). In conclusion, rate of access site crossover in the contemporary era is relatively low and can be mitigated with operator experience.
Persistent Identifierhttp://hdl.handle.net/10722/219795
ISSN
2015 Impact Factor: 3.154
2015 SCImago Journal Rankings: 2.063
PubMed Central ID
ISI Accession Number ID

 

DC FieldValueLanguage
dc.contributor.authorLe, Jeffrey-
dc.contributor.authorBangalore, Sripal-
dc.contributor.authorGuo, Yu-
dc.contributor.authorIqbal, Sohah N.-
dc.contributor.authorXu, Jinfeng-
dc.contributor.authorMiller, Louis H.-
dc.contributor.authorCoppola, John-
dc.contributor.authorShah, Binita-
dc.date.accessioned2015-09-23T02:57:58Z-
dc.date.available2015-09-23T02:57:58Z-
dc.date.issued2015-
dc.identifier.citationAmerican Journal of Cardiology, 2015, v. 116, n. 3, p. 379-383-
dc.identifier.issn0002-9149-
dc.identifier.urihttp://hdl.handle.net/10722/219795-
dc.description.abstractDespite increasing use of the transradial approach (TRA) for coronary angiography, TRA failure and subsequent access site crossover remain a barrier to TRA adoption. The aim of this study was to elucidate patient and procedural characteristics associated with TRA to transfemoral approach (TFA) crossover and examine TRA to TFA crossover by operator experience over time. This retrospective analysis identified 1,600 patients who underwent coronary angiography with possible percutaneous coronary intervention through TRA by operators with varied TRA experience in an urban tertiary care center from October 2010 to August 2013. Univariate and multivariable logistic regression were used to identify independent predictors of access site crossover, from TRA to TFA, and strength of association is presented as odds ratio (OR, 95% confidence interval [CI]). Access site crossover was noted in 166 patients (10.4%). Multivariable predictors of access site crossover included age >75 years (OR 1.90, 95% CI 1.23 to 2.91, p = 0.004) and operator experience (OR 2.98, 95% CI 1.96 to 4.52, p <0.0001). Less experienced operators (≤5 years TRA experience) had a decrease in access site crossover over time (quartile 1: 8.9%, quartile 2: 18.8%, quartile 3: 16.4%, and quartile 4: 8.6%, p <0.001), which paralleled an increase in the proportion of procedures using initial TRA over time (quartile 1: 38.0%, quartile 2: 53.7%, quartile 3: 54.8%, and quartile 4: 70.3%, p <0.001). Experienced operators (;gt;5 years TRA experience) had no significant change in proportion of access site crossover over time (quartile 1: 2.8%, quartile 2: 6.4%, quartile 3: 5.6%, quartile 4: 5.8%, p = 0.54). In conclusion, rate of access site crossover in the contemporary era is relatively low and can be mitigated with operator experience.-
dc.languageeng-
dc.relation.ispartofAmerican Journal of Cardiology-
dc.titlePredictors of Access Site Crossover in Patients Who Underwent Transradial Coronary Angiography-
dc.typeArticle-
dc.description.natureLink_to_subscribed_fulltext-
dc.identifier.doi10.1016/j.amjcard.2015.04.051-
dc.identifier.pmid26026865-
dc.identifier.pmcidPMC4499487-
dc.identifier.scopuseid_2-s2.0-84937518214-
dc.identifier.hkuros260481-
dc.identifier.volume116-
dc.identifier.issue3-
dc.identifier.spage379-
dc.identifier.epage383-
dc.identifier.eissn1879-1913-
dc.identifier.isiWOS:000359034100007-

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