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Obese pci access

Jimmy Yee, Vishesh Kumar, Shenjing Li, Terezia Petraskova, Alex Pham, Julia Stys, Paul A Thompson, Marian Petrasko, Adam Stys, Tomasz Stys
OBJECTIVES: To analyze clinical factors associated with operator's preference in selection of femoral versus radial access for angiography and percutaneous intervention (PCI) procedures. BACKGROUND: There has been an increase in radial access in cardiac catheterization and PCI in the last few decades. METHODS: Data from 11 226 consecutive cardiac catheterization procedures were collected from Sanford University Medical Center (University of South Dakota, Sanford School of Medicine) from 2011 to 2015...
December 25, 2017: Journal of Interventional Cardiology
Derek M Biederman, Brett Marinelli, Paul J O'Connor, Joseph J Titano, Rahul S Patel, Edward Kim, Nora E Tabori, Francis S Nowakowski, Robert A Lookstein, Aaron M Fischman
PURPOSE: Transradial access (TRA) has been shown to lower morbidity and bleeding complications compared to transfemoral access in percutaneous coronary interventions. Morbid obesity, commonly defined as a body mass index (BMI) ≥40 kg/m2, has been shown to be a risk factor for access site complications irrespective of access site. This study evaluates the safety and feasibility of performing visceral endovascular interventions in morbidly obese patients via TRA. METHODS: Procedural details, technical success, and 30-day major and minor access site, bleeding, and neurological adverse events were prospectively recorded in a database of 1057 procedures performed via the radial artery...
May 7, 2016: Journal of Vascular Access
Kornelia Kotseva, Dirk De Bacquer, Catriona Jennings, Viveca Gyberg, Guy De Backer, Lars Rydén, Philippe Amouyel, Jan Bruthans, Renata Cifkova, Jaap W Deckers, Johan De Sutter, Zlatko Fraz, Ian Graham, Irena Keber, Seppo Lehto, David Moore, Andrzej Pajak, David Wood
BACKGROUND: The EUROASPIRE (European Action on Secondary and Primary Prevention by Intervention to Reduce Events) cross-sectional surveys describe time trends in lifestyle and risk factor control among coronary patients between 1999 and 2013 in Belgium, Czech Republic, Finland, France, Ireland, the Netherlands, Poland, Slovenia, and the United Kingdom as part of the EuroObservational Research Programme under the auspices of European Society of Cardiology. OBJECTIVES: This study sought to describe time trends in lifestyle, risk factor control, and the use of evidence-based medication in coronary patients across Europe...
December 2017: Global Heart
Jonathan R McDonagh, Milan Seth, Thomas A LaLonde, Akshay K Khandewal, David H Wohns, Simon R Dixon, Hitinder S Gurm
OBJECTIVE: To examine if transradial approach (TRA) negates the increased risk associated with femoral access in lean and morbidly obese patients undergoing percutaneous coronary intervention (PCI). BACKGROUND: Patients at extremes of body mass are at increased risk of bleeding after PCI. TRA has been associated with lower overall rates of bleeding compared to femoral approach. METHODS AND RESULTS: We studied patients undergoing emergent and elective PCI from 2010 to 2012 across 47 hospitals in Michigan who participate in the Blue Cross Blue Shield of Michigan Cardiovascular Consortium PCI registry...
February 1, 2016: Catheterization and Cardiovascular Interventions
Kornelia Kotseva, David Wood, Dirk De Bacquer, Guy De Backer, Lars Rydén, Catriona Jennings, Viveca Gyberg, Philippe Amouyel, Jan Bruthans, Almudena Castro Conde, Renata Cífková, Jaap W Deckers, Johan De Sutter, Mirza Dilic, Maryna Dolzhenko, Andrejs Erglis, Zlatko Fras, Dan Gaita, Nina Gotcheva, John Goudevenos, Peter Heuschmann, Aleksandras Laucevicius, Seppo Lehto, Dragan Lovic, Davor Miličić, David Moore, Evagoras Nicolaides, Raphael Oganov, Andrzej Pajak, Nana Pogosova, Zeljko Reiner, Martin Stagmo, Stefan Störk, Lale Tokgözoğlu, Dusko Vulic
AIMS: To determine whether the Joint European Societies guidelines on cardiovascular prevention are being followed in everyday clinical practice of secondary prevention and to describe the lifestyle, risk factor and therapeutic management of coronary patients across Europe. METHODS AND RESULTS: EUROASPIRE IV was a cross-sectional study undertaken at 78 centres from 24 European countries. Patients <80 years with coronary disease who had coronary artery bypass graft, percutaneous coronary intervention or an acute coronary syndrome were identified from hospital records and interviewed and examined ≥ 6 months later...
April 2016: European Journal of Preventive Cardiology
Herman Kado, Ambar M Patel, Siva Suryadevara, Martin M Zenni, Lyndon C Box, Dominick J Angiolillo, Theodore A Bass, Luis A Guzman
OBJECTIVES: This study sought to assess radiation exposure and operator discomfort when using left radial approach (LRA) versus right radial approach (RRA) for coronary diagnostic and percutaneous interventions. BACKGROUND: The transradial approach is increasingly being adopted as the preferred vascular access for coronary interventions. Currently, most are performed using an RRA. This is in part due to the perceived increased operator physical discomforts as well increased radiation exposure with an LRA...
July 2014: JACC. Cardiovascular Interventions
Saeed Payvar, Sunghee Kim, Sunil V Rao, Ronald Krone, Megan Neely, Nikhil Paladugu, Ramesh Daggubati
OBJECTIVES: The purpose of this study was to compare in-hospital outcomes of percutaneous coronary intervention (PCI) in extreme obesity (EO) (body mass index [BMI] ≥ 40 kg/m²) with those of normal-weight (NW) patients and to examine the influence of access site on outcomes. BACKGROUND: Little is known about the outcomes of PCI in EO patients. METHODS: We analyzed CathPCI Registry data from patients who underwent radial or femoral PCI and were discharged between July 2009 and June 2011 and compared in-hospital outcomes of EO (N = 83,861) with those of NW patients (BMI 20 to 25 kg/m²; N = 217,616)...
August 20, 2013: Journal of the American College of Cardiology
Benjamin Hibbert, Trevor Simard, Kumanan R Wilson, Steven Hawken, George A Wells, F Daniel Ramirez, Michel R Le May, Derek Y So, Chris A Glover, Michael Froeschl, Jean-Francois Marquis, Marino Labinaz, Alexander Dick, Edward R O'Brien
OBJECTIVES: This study sought to evaluate the safety and efficacy of transradial versus transfemoral access for coronary angiography and percutaneous coronary intervention in patients with a body mass index ≥ 40 kg/m(2). BACKGROUND: Coronary angiography is most commonly performed via femoral artery access; however, the optimal approach in extremely obese (EO) patients remains unclear. METHODS: Between January 2007 and August 2010, a cohort of consecutive EO patients who underwent coronary angiography was identified in our center's registry of angiography and percutaneous coronary intervention procedures...
August 2012: JACC. Cardiovascular Interventions
Jason C Kovacic, Paul Lee, Usman Baber, Rucha Karajgikar, Solene M Evrard, Pedro Moreno, Roxana Mehran, Valentin Fuster, George Dangas, Samin K Sharma, Annapoorna S Kini
AIMS: Mounting data support a 'calcification paradox', whereby reduced bone mineral density is associated with increased vascular calcification. Furthermore, reduced bone mineral density is prevalent in older persons with lower body mass index (BMI). Therefore, although BMI and coronary artery calcification (CAC) exhibit a positive relationship in younger persons, it is predicted that in older persons and/or those at risk for osteoporosis, an inverse relationship between BMI and CAC may apply...
March 2012: Atherosclerosis
Annemieke Visser, Marlies Noordzij, Ron T Gansevoort, Wim Van Biesen, Sijmen A Reijneveld, Kitty J Jager, Paul E de Jong, Gerbrand J Izaks, Geke J Dijkstra, Johan De Meester, Andries J Hoitsma, Casper F M Franssen
AIM: This study investigates the difference in the incidence of renal replacement therapy (RRT) between Flanders and the Netherlands and possible explanations for this difference. METHODS: End-stage renal disease incidence data were obtained from the European Renal Association-European Dialysis and Transplant Association (ERA-EDTA). Additional sources were the National Institute of Statistics (NIS), the Central Bureau of Statistics (CBS), the Organisation for Economic Cooperation and Development (OECD) health data and the WHO Health For All database (WHO-HFA)...
February 2012: Nephrology, Dialysis, Transplantation
Sashko Kedev
Periprocedural bleeding and vascular complications after percutaneous coronary intervention (PCI) are associated with worse clinical outcomes and increased short- and long-term mortality. Vascular access-related bleeding accounts for more than 80% of all major bleeding events in PCI performed by the transfemoral approach. Transradial approach (TRA), on the other hand, virtually eliminates access site bleeding and vascular complications. Although clinical trials have mostly evaluated different pharmacological strategies for reducing bleeding risk, adoption of a radial rather than a femoral access may allow greater reductions in bleeding complications than pharmacological strategies alone...
June 2011: Türk Kardiyoloji Derneği Arşivi: Türk Kardiyoloji Derneğinin Yayın Organıdır
P T Chiam, V Y Lim
Transradial coronary angiography and intervention has become a popular technique due to reduced local and bleeding complications, easier post-procedural care and patient preference. In certain patients, transradial access may not be possible due to various anatomical reasons. Usually, the transfemoral route is used for these patients. In a minority of patients, such as those with significant peripheral arterial disease or obesity, the transfemoral approach is challenging and is associated with an increased risk of local complications or bleeding...
May 2010: Singapore Medical Journal
Hakim Benamer, Yves Louvard, Marcelo Sanmartin, Orazio Valsecchi, David Hildick-Smith, Philippe Garot, Inga Narbute, Martial Hamon, Imre Ungi, Jacques Monsegu
AIMS: The incidence of obesity is increasing continuously in industrial countries. Vascular complications after the transfemoral approach (TF) for either coronary angiography (CA) or angioplasty (PCI) are more frequent in this population. The transradial approach may decrease the risk of such complications. METHODS AND RESULTS: We undertook a prospective, multicentre, European registry of overweight patients (BMI >/=35), undergoing CA and/or PCI in centres with broad experience in the transradial approach (TR)...
November 2007: EuroIntervention
Jonathan Byrne, Mark S Spence, Eric Fretz, Richard Mildenberger, Alex Chase, Brian Berry, David Pi, Christian Janssen, Peter Klinke, David Hilton
The incidence of obesity is increasing throughout the industrialized world and is a major public health concern. Some studies have shown a paradoxical protective effect of moderate obesity on outcome after percutaneous coronary intervention (PCI). The association between bleeding, body mass, and outcome is not well established and formed the basis for the present study, which examined major bleeding rates and mortality after PCI in British Columbia during a 6-year period. We identified 38,346 consecutive patients from the British Columbia Cardiac Registry who underwent PCI from 1999 to 2005...
February 15, 2009: American Journal of Cardiology
Colin D Chue, Lucy E Hudsmith, Oliver Stumper, Joseph De Giovanni, Sara A Thorne, Paul Clift
OBJECTIVE: To determine the rate of vascular access complications in patients with adult congenital heart disease (ACHD). BACKGROUND: Complications of femoral access following coronary angiography or percutaneous coronary intervention have been studied extensively, but the complication rate following catheterization and intervention in ACHD patients is poorly documented. DESIGN, SETTING, AND OUTCOME MEASURES: We present a retrospective audit of vascular access complications in a large tertiary ACHD center over a 12-month period...
September 2008: Congenital Heart Disease
Nicholas Cox, Frederic S Resnic, Jeffrey J Popma, Daniel I Simon, Andrew C Eisenhauer, Campbell Rogers
In this retrospective review of 5,234 cardiac catheterizations and percutaneous coronary interventions, the rate of vascular complications was highest in extremely thin and morbidly obese patients and lowest in moderately obese patients, consistent with the previously reported "obesity paradox." The use of transradial access and arterial access closure devices was associated with reduced vascular complications in the population of obese patients.
November 1, 2004: American Journal of Cardiology
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