Coronary Artery DiseasePredictors of Access Site Crossover in Patients Who Underwent Transradial Coronary Angiography
Section snippets
Methods
This is a retrospective study of consecutive patients who underwent a diagnostic coronary angiography with or without PCI using TRA at a tertiary care center from October 2010 to August 2013. Patients who underwent a planned PCI without a diagnostic component were not included. For patients who had >1 procedure using TRA during the study period, only the first chronological procedure was selected. During this study period, transition to the opposite radial or ulnar artery was not routinely
Results
Of the 1,600 patients who met inclusion and exclusion criteria, 166 patients (10.4%) experienced access site crossover. Baseline characteristics of the group that did versus those that did not undergo access site crossover are listed in Table 1. The proportion of female patients >75 years did not differ between the crossover versus no crossover groups (7.2% vs 5.6%, p = 0.383).
Procedural characteristics of access site crossover versus no crossover groups are listed in Table 2. Timing of access
Discussion
This is one of the larger contemporary studies to examine access site crossover (from TRA to TFA) in an all-comers population who underwent coronary angiography with possible PCI by operators with varied TRA experience in a US center. In this study, the proportion of access site crossover appears to be largely driven by patient age and operator experience. Rate of access site crossover in those with less TRA experience decreases over time as operator utilization of TRA increases, suggesting
Disclosures
Dr. Shah was partially funded by a National Institutes of Health grant UL1 TR000038. Part of the data analysis and statistical support was provided by the New York University School of Medicine Cardiovascular Outcomes Group. Dr. Coppola is a consultant for Terumo and speaker for Medtronic. The authors have no conflicts of interest in relation to this article.
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