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Radial versus femoral

Romain Didier, Marco A Magalhaes, Edward Koifman, Florent Leven, Philippe Castellant, Jacques Boschat, Yannic Jobic, Sarkis Kiramijyan, Pierre-Philippe Nicol, Martine Gilard
AIMS: The radiation exposure resulting from cardiovascular procedures may increase the risk of cancer, and/or cause skin injury. Whether the novel cardiovascular automated radiation reduction X-ray system (CARS) can help reduce the patient radiation dose in daily clinical practice remains unknown. The aim of this study was to evaluate the reduction in patient radiation dose with the use of CARS in the cardiac catheterisation laboratory (CCL). METHODS AND RESULTS: This study retrospectively analysed 1,403 consecutives patients who underwent a cardiac catheterisation with coronary angiography (CA) and/or a percutaneous coronary intervention (PCI) in the Brest University Hospital over the course of one year...
October 10, 2016: EuroIntervention
Florian Schmaranzer, Pascal C Haefeli, Markus S Hanke, Emanuel F Liechti, Stefan F Werlen, Klaus A Siebenrock, Moritz Tannast
BACKGROUND: Delayed gadolinium-enhanced MRI of cartilage (dGEMRIC) allows an objective, noninvasive, and longitudinal quantification of biochemical cartilage properties. Although dGEMRIC has been used to monitor the course of cartilage degeneration after periacetabular osteotomy (PAO) for correction of hip dysplasia, such longitudinal data are currently lacking for femoroacetabular impingement (FAI). QUESTIONS/PURPOSES: (1) How does the mean acetabular and femoral dGEMRIC index change after surgery for FAI at 1-year followup compared with a similar group of patients with FAI treated without surgery? (2) Does the regional distribution of the acetabular and femoral dGEMRIC index change for the two groups over time? (3) Is there a correlation between the baseline dGEMRIC index and the change of patient-reported outcome measures (PROMs) at 1-year followup? (4) Among those treated surgically, can dGEMRIC indices distinguish between intact and degenerated cartilage? METHODS: We performed a prospective, comparative, nonrandomized, longitudinal study...
October 5, 2016: Clinical Orthopaedics and related Research
Mitchell Brooks, Chris Ellis, Greg Gamble, Gerry Devlin, John Elliott, Chris Hammett, Derek Chew, John French, Tom Briffa, Julie Redfern, Jamie Rankin, Karice Hyun, Mario D'Souza, David Brieger
BACKGROUND: There is wide variation in the use of radial over femoral access for patients with ACS. This study evaluates the factors associated with the selection of radial versus femoral angiography in Australia and New Zealand and the effect of access site on clinical events in acute coronary syndrome (ACS) patients. METHODS: An analysis of the SNAPSHOT ACS audit was conducted during May 2012 across 286 hospitals in Australia and New Zealand. Data collected included baseline patient characteristics, hospital site details, treatment received, clinical events in-hospital and mortality at 18 months...
August 22, 2016: Heart, Lung & Circulation
Marie Aouad-Maroun, Christian K Raphael, Samia K Sayyid, Fadi Farah, Elie A Akl
BACKGROUND: Arterial line cannulation in paediatric patients is traditionally performed by palpation or with Doppler auditory assistance in locating the artery before catheterization. It is not clear whether ultrasound guidance offers benefits over these methods. OBJECTIVES: To assess first attempt success rates and complication rates when ultrasound guidance is used for arterial line placement in the paediatric population, as compared with traditional techniques (palpation, Doppler auditory assistance), at all potential sites for arterial cannulation (left or right radial, ulnar, brachial, femoral or dorsalis pedis artery)...
September 14, 2016: Cochrane Database of Systematic Reviews
Christoph E Albers, Andrea Schwarz, Markus S Hanke, Karl-Philipp Kienle, Stefan Werlen, Klaus A Siebenrock
BACKGROUND: Although the etiology of primary femoroacetabular impingement (FAI) is considered developmental, the underlying pathogenic mechanisms remain poorly understood. In particular, research identifying etiologic factors associated with pincer FAI is limited. Knowledge of the physiologic growth patterns of the acetabulum during skeletal maturation might allow conclusions on deviations from normal development that could contribute to pincer-related pathomorphologies. QUESTIONS/PURPOSES: In a population of healthy children, we asked if there were any differences related to skeletal maturation with regard to (1) acetabular version; (2) acetabular depth/width ratio; and (3) femoral head coverage in the same children as assessed by MRIs obtained 1 year apart...
September 1, 2016: Clinical Orthopaedics and related Research
Dhaval Kolte, Nathan Spence, Mohamedtauqir Puthawala, Omar Hyder, Christopher P Tuohy, Carolyn B Davidson, Mark W Sheldon, Warren K Laskey, J Dawn Abbott
BACKGROUND: Patients with ST-elevation myocardial infarction (STEMI) undergoing primary percutaneous coronary intervention (PCI) are at an increased risk of developing contrast-induced acute kidney injury (CI-AKI). Data on the association between transradial (TRA) vs. transfemoral (TFA) access and the risk of CI-AKI in this setting are limited. METHODS: We analyzed data on 1162 patients undergoing primary PCI for STEMI at two tertiary care centers between 2010 and 2014...
July 21, 2016: Cardiovascular Revascularization Medicine: Including Molecular Interventions
S Kilic, R S Hermanides, J P Ottervanger, E Kolkman, J H E Dambrink, V Roolvink, A T M Gosselink, E Kedhi, A W J van 't Hof
AIM: This study sought to assess whether radial artery access improves clinical outcomes in patients presenting with acute myocardial infarction compared with femoral artery access. METHODS: This is a single-centre, prospective observational registry of all STEMI and NSTEMI patients who underwent coronary angiography and/or primary PCI in the period January 2010 to December 2013. Primary endpoint was 30-day all-cause mortality. Choice of access was left to the discretion of the cardiologist...
August 25, 2016: Netherlands Heart Journal
David R Dobies, Kimberly R Barber, Amanda L Cohoon
OBJECTIVE: Using a multisite, contemporary registry of 58 862 percutaneous coronary intervention (PCI) procedures in a national healthcare system, the present study compared radial access with femoral access on safety and efficacy outcomes. METHODS: This is a real-world, large-scale, retrospective study using clinical data from a 137-hopsital System and reported to a multisite clinical registry. All patients undergoing a cardiac catheterisation procedure were included in this database...
2016: Open Heart
Pedro B Andrade, Luiz A Mattos, Fábio S Rinaldi, Igor C Bienert, Robson A Barbosa, André Labrunie, Marden Tebet, Vinícius Esteves, Alexandre Abizaid, Amanda R Sousa
OBJECTIVES: To compare the radial versus femoral approach using Angio-Seal for the incidence of access site complications among non-ST-segment elevation acute coronary syndrome patients undergoing invasive strategy. BACKGROUND: Arterial access is a major site of complications after invasive coronary procedures. Vascular closure devices provide more comfort to patients decreasing time to hemostasis and need for bed rest. However, the inconsistency of data proving their safety limits their routine adoption as a strategy to prevent vascular complications...
August 12, 2016: Catheterization and Cardiovascular Interventions
Michael P Thomas, Eric R Bates
Primary PCI is the dominant reperfusion strategy for patients with ST-elevation myocardial infarction and continues to evolve. The purpose of this review is to summarize recent reports that focused on the relationship of door-to-balloon time with mortality, radial versus femoral artery access, aspiration thrombectomy, culprit versus multivessel primary PCI, drug-eluting stents, and anticoagulation and antiplatelet therapies.
June 27, 2016: Trends in Cardiovascular Medicine
Rasmus K Carlsen, Christian D Peters, Dinah S Khatir, Esben Laugesen, Hans Erik Bøtker, Simon Winther, Niels H Buus
Central blood pressure (BP) can be assessed noninvasively based on radial tonometry and may potentially be a better predictor of clinical outcome than brachial BP. However, the validity of noninvasively obtained estimates has never been examined in patients with chronic kidney disease (CKD). Here we compared invasive aortic systolic BP (SBP) with estimated central SBP obtained by radial artery tonometry and examined the influence of renal function and arterial stiffness on this relationship. We evaluated 83 patients with stage 3 to 5 CKD (mean estimated glomerular filtration rate [eGFR] 30 ml/min/1...
October 2016: Kidney International
Giuseppe Ferrante, Sunil V Rao, Peter Jüni, Bruno R Da Costa, Bernhard Reimers, Gianluigi Condorelli, Angelo Anzuini, Sanjit S Jolly, Olivier F Bertrand, Mitchell W Krucoff, Stephan Windecker, Marco Valgimigli
OBJECTIVES: The aim of this study was to provide a quantitative appraisal of the effects on clinical outcomes of radial access for coronary interventions in patients with coronary artery disease (CAD). BACKGROUND: Randomized trials investigating radial versus femoral access for percutaneous coronary interventions have provided conflicting evidence. No comprehensive quantitative appraisal of the risks and benefits of each approach is available across the whole spectrum of patients with stable or unstable CAD...
July 25, 2016: JACC. Cardiovascular Interventions
Fadi J Sawaya, Yves Louvard, Marco Spaziano, Marie-Claude Morice, Fouad Hage, Carlos El-Khoury, Andrew Roy, Philippe Garot, Thomas Hovasse, Hakim Benamer, Thierry Unterseeh, Bernard Chevalier, Stéphane Champagne, Jean-François Piechaud, Didier Blanchard, Bertrand Cormier, Thierry Lefèvre
BACKGROUND: Although the trans-radial approach (TR) has been applied to various subsets of patients in percutaneous coronary intervention, the feasibility, efficacy, acute procedural and long-term outcomes of TR versus trans-femoral approach (TF) for alcohol septal ablation (ASA) have not yet been determined. OBJECTIVES: The aim of this study was to compare the short and long-term outcomes of ASA with the TR approach compared to the TF approach. METHODS: We retrospectively analyzed 240 patients who underwent an ASA procedure at our institution from November 1999 to November 2015...
October 1, 2016: International Journal of Cardiology
Bela Kis, Matthew Mills, Sarah E Hoffe
PURPOSE: Despite the growing evidence in the cardiology literature that transradial approach has substantial benefits over transfemoral access, this technique is rarely used during interventions in the systemic circulation. The aim of this study was to evaluate the feasibility of transradial approach for hepatic radioembolization and to compare it with transfemoral approach. METHODS: Sixty-four hepatic radioembolizations performed in 50 patients were included in the study...
September 2016: Diagnostic and Interventional Radiology: Official Journal of the Turkish Society of Radiology
Tobias Becher, Michael Behnes, Melike Ünsal, Stefan Baumann, Ibrahim El-Battrawy, Christian Fastner, Jürgen Kuschyk, Theano Papavassiliu, Ursula Hoffmann, Kambis Mashayekhi, Martin Borggrefe, Ibrahim Akin
BACKGROUND: Data regarding radiation exposure related to radial versus femoral arterial access in patients undergoing percutaneous coronary intervention (PCI) remain controversial. This study aims to evaluate patients enrolled in the FERARI study regarding radiation exposure, fluoroscopy time and contrast agent use. METHODS: The Femoral Closure versus Radial Compression Devices Related to Percutaneous Coronary Interventions (FERARI) study evaluated prospectively 400 patients between February 2014 and May 2015 undergoing PCI either using the radial or femoral access...
June 15, 2016: Cardiovascular Revascularization Medicine: Including Molecular Interventions
Stephanie W Mayer, João Caetano Munhoz Abdo, Mary K Hill, Lauryn A Kestel, Zhaoxing Pan, Eduardo N Novais
BACKGROUND: Femoroacetabular impingement (FAI) deformity has been associated with posterior hip instability in adult athletes. PURPOSE: To determine if FAI deformity is associated with posterior hip instability in adolescents, the femoral head-neck junction or acetabular structure in a cohort of adolescent patients who sustained a low-energy, sports-related posterior hip dislocation was compared with that in a group of healthy age- and sex-matched controls with no history of hip injury or pain...
September 2016: American Journal of Sports Medicine
On Chen, Sunny Goel, Michael Acholonu, Guy Kulbak, Shivani Verma, Efstratios Travlos, Richard Casazza, Elliot Borgen, Bilal Malik, Michael Friedman, Norbert Moskovits, Robert Frankel, Jacob Shani, Sergey Ayzenberg
In this prospective, randomized controlled study, we aim to compare the performance outcomes of standard catheters with the radial artery-specific catheter. Over the past decade, transradial cardiac catheterization has gained widespread popularity because of its low complication rates compared with transfemoral access. Operators have the choice of using either standard catheters (used for both transfemoral and transradial approach, with need for separate catheter use for either right or left coronary artery engagement) or a dedicated radial artery catheter, which is specifically designed to engage both coronary arteries through radial artery access...
August 1, 2016: American Journal of Cardiology
Ali Abdul Jabbar, Omar Mufti, Angeline Sabol, Ronald Markert, Bryan White, George Broderick
Bleeding is a major limitation of antithrombotic therapy among invasively managed patients with non-ST-segment elevation acute coronary syndromes (NSTE-ACSs). Randomized clinical trials have generally failed to favor either the femoral or the radial arterial approach for coronary angiography or intervention in NSTE-ACS. In 561 hospitalized patients with a new diagnosis of NSTE-ACS referred for coronary angiography, 364 and 197 patients underwent the femoral and the radial approach, respectively. Femoral and radial access did not differ in bleeding complications in the first 72 hours (8 of 364 or 2...
June 1, 2016: Angiology
Bernadette Speiser, Katrina Pearson, Hui Xie, Adhir R Shroff, Mladen I Vidovich
OBJECTIVES: To determine ambulation times after right heart catheterization (RHC) via upper extremity access compared to femoral venous access. BACKGROUND: Transradial coronary angiography has been associated with shorter times to ambulation. We hypothesized that RHC from the upper extremity would be similarly associated with shorter ambulation times when compared to traditional femoral access. METHODS: We performed a single-center retrospective analysis of 379 consecutive patients who underwent a variety of diagnostic and interventional left- and right-heart procedures through upper extremity and femoral access sites...
May 19, 2016: Catheterization and Cardiovascular Interventions
Gurpreet Singh, Enrique Campos, Clifford J Kavinsky, Jeffrey R Snell, Gary L Schaer, Neeraj Jolly
OBJECTIVES: This study was conducted to evaluate the differences in the procedural variables between transradial and transfemoral access for coronary angiography, with cardiology fellows as the primary operators. METHODS: This was a retrospective study of 163 radial and 180 femoral access diagnostic cardiac catheterization procedures, and involved cardiology fellowship trainees as primary operators. RESULTS: The radial approach was associated with significantly higher fluoroscopy time (8...
June 2016: Journal of Invasive Cardiology
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