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Radial versus femoral

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https://www.readbyqxmd.com/read/28544320/influence-of-radial-versus-femoral-access-site-on-coronary-angiography-and-intervention-outcomes-a-systematic-review-and-meta-analysis
#1
Michael I Brener, Aaron Bush, Julie M Miller, Rani K Hasan
OBJECTIVES: Systematic review and meta-analysis of randomized clinical trials (RCT) to compare procedural outcomes between radial access (RA) and femoral access (FA). BACKGROUND: Recent RCTs suggest RA for coronary angiography and percutaneous coronary intervention reduces bleeding complications, but controversy exists regarding other benefits and risks relative to FA. METHODS: Searches of MEDLINE, EMBASE, CENTRAL, LILACS, and major conference abstracts identified relevant studies published from 1985-2016...
May 25, 2017: Catheterization and Cardiovascular Interventions
https://www.readbyqxmd.com/read/28528767/acute-kidney-injury-after-radial-or-femoral-access-for-invasive-acute-coronary-syndrome-management-aki-matrix
#2
Giuseppe Andò, Bernardo Cortese, Filippo Russo, Martina Rothenbühler, Enrico Frigoli, Giuseppe Gargiulo, Carlo Briguori, Pascal Vranckx, Sergio Leonardi, Vincenzo Guiducci, Flavia Belloni, Fabio Ferrari, Jose Maria de la Torre Hernandez, Salvatore Curello, Francesco Liistro, Andrea Perkan, Stefano De Servi, Gavino Casu, Antonio Dellavalle, Dionigi Fischetti, Antonio Micari, Bruno Loi, Fabio Mangiacapra, Nunzio Russo, Fabio Tarantino, Francesco Saia, Dik Heg, Stephan Windecker, Peter Jüni, Marco Valgimigli
BACKGROUND: It remains unclear whether radial access (RA), compared with femoral access (FA), mitigates the risk of acute kidney injury (AKI). OBJECTIVES: The authors assessed the incidence of AKI in patients with acute coronary syndrome (ACS) enrolled in the MATRIX-Access (Minimizing Adverse Haemorrhagic Events by Transradial Access Site and Systemic Implementation of Angiox) trial. METHODS: Among 8,404 patients, 194 (2.3%) were excluded due to missing creatinine values, no or an incomplete coronary angiogram, or previous dialysis...
May 11, 2017: Journal of the American College of Cardiology
https://www.readbyqxmd.com/read/28525886/relationship-between-arterial-access-and-outcomes-in-st-elevation-myocardial-infarction-with-a-pharmacoinvasive-versus-primary-percutaneous-coronary-intervention-strategy-insights-from-the-strategic-reperfusion-early-after-myocardial-infarction-stream-study
#3
Jay Shavadia, Robert Welsh, Anthony Gershlick, Yinggan Zheng, Kurt Huber, Sigrun Halvorsen, Phillipe G Steg, Frans Van de Werf, Paul W Armstrong
BACKGROUND: The effectiveness of radial access (RA) in ST-elevation myocardial infarction (STEMI) has been predominantly established in primary percutaneous coronary intervention (pPCI) with limited exploration of this issue in the early postfibrinolytic patient. The purpose of this study was to compare the effectiveness and safety of RA versus femoral (FA) access in STEMI undergoing either a pharmacoinvasive (PI) strategy or pPCI. METHODS AND RESULTS: Within STrategic Reperfusion Early After Myocardial Infarction (STREAM), we evaluated the relationship between arterial access site and primary outcome (30-day composite of death, shock, congestive heart failure, or reinfarction) and major bleeding according to the treatment strategy received...
June 13, 2016: Journal of the American Heart Association
https://www.readbyqxmd.com/read/28523028/peripheral-arterial-blood-pressure-versus-central-crterial-blood-pressure-monitoring-in-critically-ill-patients-after-cardio-pulmonary-bypass
#4
Rana Altaf Ahmad, Suhail Ahmad, Anjum Naveed, Mirza Ahmad Raza Baig
OBJECTIVE: To determine the accuracy of peripheral (radial) arterial access as compared to central (femoral) arterial access for measurement of invasive blood pressure (IBP) in critically ill patients after cardiopulmonary bypass. METHODS: Sixty patients (60) who required high inotropic/vasopressor support on weaning from cardio-pulmonary bypass and weaned off in 2(nd) attempt were included in this study. The duration of this study was from June 2015 to August 2016...
March 2017: Pakistan Journal of Medical Sciences Quarterly
https://www.readbyqxmd.com/read/28495430/patient-versus-physician-variation-in-use-of-transradial-percutaneous-coronary-intervention
#5
Shariq Shamim, Fengming Tang, David Safley, Philip Jones, John A Spertus, Dmitri Baklanov
The prevalence of radial access for transradial catheterization remains low in the United States, occurring in only 28% of cases in the National Cardiovascular Data Registry (NCDR) CathPCI. It is unknown whether the low adoption rate has been influenced by patient characteristics or is more operator dependent. In a 10-center study, we compared clinical and demographic characteristics among 323 radial and 1,506 femoral access percutaneous coronary intervention (PCIs) performed by 65 interventionists capable of radial PCI...
March 30, 2017: American Journal of Cardiology
https://www.readbyqxmd.com/read/28487035/radial-versus-femoral-access-for-the-treatment-of-left%C3%A2-main-lesion-in-the-era-of-second-generation-drug-eluting-stents
#6
Sebastiano Gili, Fabrizio D'Ascenzo, Roberto Di Summa, Federico Conrotto, Enrico Cerrato, Alaide Chieffo, Giacomo Boccuzzi, Antonio Montefusco, Fabrizio Ugo, Pierluigi Omedé, Hiroyoshi Kawamoto, Francesco Tomassini, Marco Pavani, Ferdinando Varbella, Roberto Garbo, Maurizio D'Amico, Giuseppe Biondi Zoccai, Claudio Moretti, Javier Escaned, Antonio Colombo, Fiorenzo Gaita
Transradial access (TRA) is often avoided in favor of the transfemoral access (TFA) during percutaneous coronary interventions of the unprotected left main coronary artery (ULM), due to technical and safety concerns. The aim of this study was to compare the performance of TRA and TFA in the treatment of ULM with second-generation drug-eluting stents. Consecutive patients who underwent percutaneous coronary intervention on ULM with second-generation drug-eluting stents were retrospectively enrolled in the multicenter Failure in Left Main Study With 2nd Generation Stents (FAILS 2) registry...
April 12, 2017: American Journal of Cardiology
https://www.readbyqxmd.com/read/28470994/patient-preference-for-radial-versus-femoral-vascular-access-for-elective-coronary-procedures-the-prevas-study
#7
Marlies M Kok, Marieke G M Weernink, Clemens von Birgelen, Anneloes Fens, Liefke C van der Heijden, Janine A van Til
OBJECTIVES: To explore patient preference for vascular access site in percutaneous coronary procedures, the perceived importance of benefits and risks of transradial access (TRA) and transfemoral access (TFA) were assessed. In addition, direct preference for vascular access and preference for shared decision making (SDM) were evaluated. BACKGROUND: TRA has gained significant ground on TFA during the last decades. Surveys on patient preference have mostly been performed in dedicated TRA trials...
May 4, 2017: Catheterization and Cardiovascular Interventions
https://www.readbyqxmd.com/read/28465122/authentication-of-radial-versus-femoral-arterial-pressure-waveform-derived-cardiac-output-with-transesophageal-echocardiography-derived-cardiac-output-measurements-in-patients-undergoing-on-pump-coronary-bypass-surgery
#8
Madan Mohan Maddali, Niranjan Dilip Waje, Panchatcharam Murthi Sathiya
OBJECTIVE: The aim of this study was to ascertain if arterial waveform-derived cardiac output measurements from radial and femoral cannulation sites were reliable as compared with transesophageal echocardiography (TEE)-derived cardiac output (CO) values, and which of the CO measurements derived from radial and the femoral arterial pressure waveforms closely tracked simultaneously measured TEE-derived CO values. This study also aimed to ascertain if cardiopulmonary bypass (CPB) would impact the accuracy of arterial pressure-derived CO values from either of the 2 sites...
February 3, 2017: Journal of Cardiothoracic and Vascular Anesthesia
https://www.readbyqxmd.com/read/28444935/hydration-status-influences-the-measurement-of-arterial-stiffness
#9
Aaron R Caldwell, Matthew A Tucker, Jenna Burchfield, Nicole E Moyen, Alf Z Satterfield, Ashley Six, Brendon P McDermott, Sean W Mulvenon, Matthew S Ganio
Consensus guidelines have attempted to standardize the measurement and interpretation of pulse wave velocity (PWV); however, guidelines have not addressed whether hydration status affects PWV. Moreover, multiple studies have utilized heat stress to reduce arterial stiffness which may lead to dehydration. This study utilized two experiments to investigate the effects of dehydration on PWV at rest and during passive heat stress. In experiment 1, subjects (n = 19) completed two trials, one in which they arrived euhydrated and one dehydrated (1·2[1·0]% body mass loss)...
April 26, 2017: Clinical Physiology and Functional Imaging
https://www.readbyqxmd.com/read/28364031/the-effect-of-acute-maximal-exercise-on-postexercise-hemodynamics-and-central-arterial-stiffness-in-obese-and-normal-weight-individuals
#10
Kanokwan Bunsawat, Sushant M Ranadive, Abbi D Lane-Cordova, Huimin Yan, Rebecca M Kappus, Bo Fernhall, Tracy Baynard
Central arterial stiffness is associated with incident hypertension and negative cardiovascular outcomes. Obese individuals have higher central blood pressure (BP) and central arterial stiffness than their normal-weight counterparts, but it is unclear whether obesity also affects hemodynamics and central arterial stiffness after maximal exercise. We evaluated central hemodynamics and arterial stiffness during recovery from acute maximal aerobic exercise in obese and normal-weight individuals. Forty-six normal-weight and twenty-one obese individuals underwent measurements of central BP and central arterial stiffness at rest and 15 and 30 min following acute maximal exercise...
April 2017: Physiological Reports
https://www.readbyqxmd.com/read/28330794/radiation-exposure-and-vascular-access%C3%A2-in%C3%A2-acute-coronary-syndromes-the-rad-matrix-trial
#11
Alessandro Sciahbasi, Enrico Frigoli, Alessandro Sarandrea, Martina Rothenbühler, Paolo Calabrò, Alessandro Lupi, Francesco Tomassini, Bernardo Cortese, Stefano Rigattieri, Enrico Cerrato, Dennis Zavalloni, Antonio Zingarelli, Paolo Calabria, Paolo Rubartelli, Gennaro Sardella, Matteo Tebaldi, Stephan Windecker, Peter Jüni, Dik Heg, Marco Valgimigli
BACKGROUND: It remains unclear whether radial access increases the risk of operator or patient radiation exposure compared to transfemoral access when performed by expert operators. OBJECTIVES: This study sought to determine whether radial access increases radiation exposure. METHODS: A total of 8,404 patients, with or without ST-segment elevation acute coronary syndrome, were randomly assigned to radial or femoral access for coronary angiography and percutaneous intervention, and collected fluoroscopy time and dose-area product (DAP)...
May 23, 2017: Journal of the American College of Cardiology
https://www.readbyqxmd.com/read/28329389/radial-versus-femoral-access-in-patients-with-acute-coronary-syndromes-with-or-without-st-segment-elevation-a-pre-specified-analysis-from-the-randomized-minimizing-adverse-haemorrhagic-events-by-transradial-access-site-and-systemic-implementation-of-angiox
#12
Pascal Vranckx, Enrico Frigoli, Martina Rothenbühler, Francesco Tomassini, Stefano Garducci, Giuseppe Andò, Andrea Picchi, Paolo Sganzerla, Anita Paggi, Fabrizio Ugo, Arturo Ausiello, Gennaro Sardella, Nicoletta Franco, Marco Nazzaro, Nicoletta de Cesare, Paolo Tosi, Camillo Falcone, Carlo Vigna, Pietro Mazzarotto, Emilio Di Lorenzo, Claudio Moretti, Gianluca Campo, Carlo Penzo, Giampaolo Pasquetto, Dik Heg, Peter Jüni, Stephan Windecker, Marco Valgimigli
Aims: To assess whether radial compared with femoral access is associated with consistent outcomes in patients with ST-segment elevation myocardial infarction (STEMI) and non-ST-segment elevation acute coronary syndrome (NSTE-ACS). Methods and results: In the Minimizing Adverse Haemorrhagic Events by TRansradial Access Site and Systemic Implementation of angioX (MATRIX) programme patients were randomized to radial or femoral access, stratified by STEMI (2001 radial, 2009 femoral) and NSTE-ACS (2196 radial, 2198 femoral)...
February 28, 2017: European Heart Journal
https://www.readbyqxmd.com/read/28288587/the-value-of-arterial-pressure-waveform-cardiac-output-measurements-in-the-radial-and-femoral-artery-in-major-cardiac-surgery-patients
#13
A van Drumpt, J van Bommel, S Hoeks, F Grüne, T Wolvetang, J Bekkers, M Ter Horst
BACKGROUND: A relatively new uncalibrated arterial pressure waveform cardiac output (CO) measurement technique is the Pulsioflex-ProAQT® system. Aim of this study was to validate this system in cardiac surgery patients with a specific focus on the evaluation of a difference in the radial versus the femoral arterial access, the value of the auto-calibration modus and the ability to show fluid-induced changes. METHODS: In twenty-five patients scheduled for ascending aorta, aortic arch replacement, or both we measured CO simultaneously by transpulmonary thermodilution (COtd) and by using the ProAQT® system connected to the radial (COpR), as well as the femoral artery catheter (COpF)...
March 14, 2017: BMC Anesthesiology
https://www.readbyqxmd.com/read/28269220/using-multiple-placements-of-accelerometers-to-measure-cardiovascular-pulse-transit-times
#14
Natalie Kurgan Canino, Ruisheng Wang, Charles J Robinson
To measure pulse transit times (PTT) and calculate pulse wave velocities (PWV), tri-axial and uniaxial accelerometers were placed in groups of 2 to 4 over the manubrium, xiphoid process, forehead, wrist and ankle, and/or over the carotid, femoral, and posterior auricular arteries in 11 consented supine subjects. Signals were sampled at 1 kHz and filtered. Radial vectors were calculated from the tri-axial measurements. A 3-lead ECG was simultaneously collected over the same 180 s window, as well as respiratory rate...
August 2016: Conference Proceedings: Annual International Conference of the IEEE Engineering in Medicine and Biology Society
https://www.readbyqxmd.com/read/28227450/using-multiple-placements-of-accelerometers-to-measure-cardiovascular-pulse-transit-times
#15
Natalie Kurgan Canino, Ruisheng Rick Wang, Charles J Robinson, Natalie Kurgan Canino, Ruisheng Wang, Charles J Robinson, Natalie Kurgan Canino, Charles J Robinson, Ruisheng Rick Wang
To measure pulse transit times (PTT) and calculate pulse wave velocities (PWV), tri-axial and uniaxial accelerometers were placed in groups of 2 to 4 over the manubrium, xiphoid process, forehead, wrist and ankle, and/or over the carotid, femoral, and posterior auricular arteries in 11 consented supine subjects. Signals were sampled at 1 kHz and filtered. Radial vectors were calculated from the tri-axial measurements. A 3-lead ECG was simultaneously collected over the same 180 s window, as well as respiratory rate...
August 2016: Conference Proceedings: Annual International Conference of the IEEE Engineering in Medicine and Biology Society
https://www.readbyqxmd.com/read/28117244/radial-versus-femoral-access-for-coronary-angiography-and-intervention-is-associated-with-lower-patient-radiation-exposure-in-high-radial-volume-centres-insights-from-the-ray-act-1-study
#16
MULTICENTER STUDY
Jean-Louis Georges, Loic Belle, Ludovic Meunier, Thierry Dechery, Khalifé Khalifé, Max Pecheux, Simon Elhaddad, Nicolas Amabile, Michel Pansieri, Jacques Ballout, Xavier Marchand, Gilles Rouault, Pierre Leddet, Olivier Nugue, Nicolas Lucke, Simon Cattan
BACKGROUND: Literature suggests that radial access is associated with higher radiation doses than femoral access. AIMS: To compare patient radiation exposure during coronary angiography (CA) and percutaneous coronary intervention (PCI) with radial versus femoral access. METHODS: RAY'ACT is a nationwide, multicentre, French survey evaluating patient radiation in interventional cardiology. Variables of patient exposure from 21,675 CAs and 17,109 PCIs performed at 44 centres during 2010 were analysed retrospectively...
March 2017: Archives of Cardiovascular Diseases
https://www.readbyqxmd.com/read/27972305/cost-effectiveness-of-radial-access-versus-femoral-for-diagnostic-cardiac-catheterization-and-coronary-intervention-in-colombia
#17
H Borja, Y Gil-Rojas, C Castañeda-Cardona, D Rosselli
No abstract text is available yet for this article.
November 2016: Value in Health: the Journal of the International Society for Pharmacoeconomics and Outcomes Research
https://www.readbyqxmd.com/read/27969721/tct-374-propensity-score-matched-analysis-of-acute-kidney-injury-following-percutenous-coronary-intervention-with-trans-radial-versus-trans-femoral-approach
#18
Gilbert Tang, Hector Manel Garcia-Garcia, Toby Rogers, Sarkis Kiramijyan, Edward Koifman, Smita Negi, Sang Yeub Lee, Rebecca Torguson, Augusto Pichard, Lowell Satler, Itshac Itsik Ben-Dor, Ron Waksman
No abstract text is available yet for this article.
November 1, 2016: Journal of the American College of Cardiology
https://www.readbyqxmd.com/read/27860277/comparison-of-transradial-and-transfemoral-access-in-patients-undergoing-percutaneous-coronary-intervention-for-complex-coronary-lesions
#19
COMPARATIVE STUDY
Edward Koifman, Michael A Gaglia, Ricardo O Escarcega, Nelson L Bernardo, Robert A Lager, Robert A Gallino, Itsik Ben-Dor, Augusto D Pichard, Nevin C Baker, Michael J Lipinski, Sarkis Kiramijyan, Smita I Negi, Rebecca Torguson, Jiaxiang Gai, William O Suddath, Lowell F Satler, Ron Waksman
OBJECTIVE: Comparison of transradial versus transfemoral access for complex percutaneous coronary intervention (PCI) with regard to both complications and long-term outcomes. BACKGROUND: Radial access has been shown to confer superior results in patients undergoing PCI, especially in patients with acute coronary syndromes. However, radial access has limitations of sheath and device size, which may increase procedure time and result in inferior outcomes. METHODS: Patients undergoing PCI for complex lesions, defined as type C according the ACC/AHA classification system, were included in this study...
March 1, 2017: Catheterization and Cardiovascular Interventions
https://www.readbyqxmd.com/read/27823682/influence-of-access-site-choice-for-cardiac-catheterization-on-risk-of-adverse-neurological-events-a-systematic-review-and-meta-analysis
#20
REVIEW
Alex Sirker, Chun Shing Kwok, Rafail Kotronias, Rodrigo Bagur, Olivier Bertrand, Robert Butler, Colin Berry, James Nolan, Keith Oldroyd, Mamas A Mamas
BACKGROUND: Stroke is a rare but potentially catastrophic complication of cardiac catheterization. Although some procedural aspects are known to influence stroke risk, the impact of radial versus femoral access site use is unclear. Early observational studies and limited randomized trial data suggested more frequent embolic events with radial access. Subsequently, larger pooled analyses have shown no clear differences in stroke risk but were limited by low event rates. Recent publication of relevant new data prompted our reevaluation of this concern...
November 2016: American Heart Journal
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