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Radial versus femoral access for left main percutaneous coronary intervention: An analysis from the Veterans Affairs Clinical, Reporting, and Tracking Program.
Bhardwaj, Bhaskar; Gunzburger, Elise; Valle, Javier A; Grunwald, Gary K; Plomondon, Mary E; Vidovich, Mladen I; Aggarwal, Kul; Karuparthi, Poorna Raj.
Afiliación
  • Bhardwaj B; Section of Cardiology, Harry S. Truman VA Hospital, Columbia, Missouri, USA.
  • Gunzburger E; Division of Cardiovascular Disease, Department of Medicine, University of Missouri, Columbia, Missouri, USA.
  • Valle JA; VA Eastern Colorado Health Care System, Veterans Health Administration, Aurora, Colorado, USA.
  • Grunwald GK; VA Eastern Colorado Health Care System, Veterans Health Administration, Aurora, Colorado, USA.
  • Plomondon ME; VA Eastern Colorado Health Care System, Veterans Health Administration, Aurora, Colorado, USA.
  • Vidovich MI; Department of Biostatistics and Informatics, Colorado School of Public Health, University of Colorado Anschutz Medical Campus, Aurora, Colorado, USA.
  • Aggarwal K; VA CART Program, Office of Quality and Patient Safety, Veterans Health Administration, Washington, District of Columbia, USA.
  • Karuparthi PR; Section of Cardiology, Jesse Brown VA Medical Center, Chicago, Illinois, USA.
Catheter Cardiovasc Interv ; 99(2): 480-488, 2022 02.
Article en En | MEDLINE | ID: mdl-34847279
OBJECTIVES: We aimed to compare clinical characteristics and procedural outcomes of left main percutaneous interventions (LM-PCI) by transradial (TRA) versus transfemoral (TFA) approach in the VA healthcare system. BACKGROUND: TRA for percutaneous coronary intervention (PCI) is steadily increasing. However, the frequency and efficacy of TRA for LM-PCI remain less studied. METHODS: All LM-PCIs performed in the VA healthcare system were identified for fiscal year 2008 through 2018. Patients' baseline characteristics and procedure-related variables were compared by access site. Both short- and long-term clinical outcomes were analyzed using propensity score matching. RESULTS: A total of 4004 LM-PCI were performed in the VA via either radial or femoral access from 2008 to 2018. Among these, 596 (14.9%) LM PCIs were performed via TRA. Use of TRA for LM-PCI increased from 2.2% to 31.5% over the study period. Propensity matched outcome analysis, comparing TRA versus TFA, showed a similar procedural success (98.4% for TRA vs. 97.8% for TFA; RR: 1.01 [0.98, 1.03]) and 1-year major adverse cardiovascular events (MACE) (25.9% for TRA vs. 26.8% TFA; RR: 0.96 [0.74, 1.25]). There were no statistically significant differences among secondary outcomes analyses including major bleeding. CONCLUSION: Use of TRA for LM-PCI has been steadily increasing in the VA healthcare system. These findings demonstrate similar procedural success and 1-year MACE across access strategies, suggesting an opportunity to continue increasing TRA use for LM-PCI.
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Texto completo: 1 Colección: 01-internacional Base de datos: MEDLINE Asunto principal: Veteranos / Cateterismo Periférico / Intervención Coronaria Percutánea Tipo de estudio: Prognostic_studies Límite: Humans Idioma: En Revista: Catheter Cardiovasc Interv Asunto de la revista: CARDIOLOGIA Año: 2022 Tipo del documento: Article País de afiliación: Estados Unidos Pais de publicación: Estados Unidos
Texto completo
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Texto completo: 1 Colección: 01-internacional Base de datos: MEDLINE Asunto principal: Veteranos / Cateterismo Periférico / Intervención Coronaria Percutánea Tipo de estudio: Prognostic_studies Límite: Humans Idioma: En Revista: Catheter Cardiovasc Interv Asunto de la revista: CARDIOLOGIA Año: 2022 Tipo del documento: Article País de afiliación: Estados Unidos Pais de publicación: Estados Unidos