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- W2000927045 abstract "Transradial approach (TR) for coronary angiography and intervention (CA/PCI) is shown to offer significant advantages compared to the transfemoral approach (TF) in general population. However, limited information is available for the safety and efficacy of TR in the elderly, a population with higher rate of subclavian artery calcification and tortousity. A comprehensive literature search of studies comparing TR and TF in the elderly (mean age 82year) was performed. Mantel-Haenszel random effects model was used to compute odds ratio (OR) with 95% confidence intervals (CI). The primary endpoint of this study was composite of vascular complications. The secondary endpoints included access site cross over, myocardial infarction (MI), stroke and in-hospital mortality. A total of 235 studies were reviewed and 9 included in the final analysis. Clinical outcomes of 2315 patients (2 randomized and 7 observational studies) were compared between TR (995 patients, 43%) and TF (1320 patients, 57%). Compared to TF, TR resulted in significant reduction of composite vascular endpoints (4.4 vs. 12.3 %, OR 0.20, p < 0.00001), and individual subtypes, hematoma (2.7 vs. 9.2%, OR 0.25, p<0.001), pseudoaneurysm (0.4 vs. 2.1%, OR 0.28 p=0.05) and blood transfusion (2.3 vs. 2.7%, OR 0.39 p=0.04). The access site crossover was higher for TR approach (10% vs. 3.1%, OR 4.74, p=0.003) with no difference in the rate of MI, stroke and death between the two groups. Analysis of randomized studies only showed similar result. TR efficacy is preserved for CA/PCI in the elderly, significantly reduces important vascular complication compared to TF with an acceptable rate of access site cross over.View Large Image Figure ViewerDownload (PPT)" @default.
- W2000927045 created "2016-06-24" @default.
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- W2000927045 date "2014-10-01" @default.
- W2000927045 modified "2023-09-26" @default.
- W2000927045 title "LOW RATE OF CROSSOVER TO TRANSFEMORAL APPROACH WITH SUBSTANTIAL REDUCTION IN VASCULAR COMPLICATIONS AMONG OCTOGENARIANS TREATED WITH PCI VIA THE TRANSRADIAL APPROACH" @default.
- W2000927045 doi "https://doi.org/10.1016/j.cjca.2014.07.038" @default.
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