Coronary Artery DiseaseRadial Versus Femoral Access for the Treatment of Left Main Lesion in the Era of Second-Generation Drug-Eluting Stents
Section snippets
Methods
The Failure in Left Main Study With 2nd Generation Stents (FAILS 2) is a multicenter registry retrospectively enrolling patients who underwent percutaneous treatment of ULM with second-generation DES between July 2006 and March 2015.8 Five European centers were involved. All consecutive patients with indication to PCI of ULM stenosis were included, independently from clinical presentation. Patients with previous coronary artery bypass surgery, but no patent grafts supplying the left anterior
Results
Study population included 1,247 patients (23.2% [289] of female gender), with a mean age of 70.2 ± 10.2 years. Baseline features are reported in Table 1. Mean follow-up was 726 ± 654 days.
TRA was chosen in 250 patients (20.1%), and the prevalence of its use increased steadily during the course of the study, from 8.1% of the procedures performed in the period June 2006 to March 2010 to 38.7% in the period July 2013 to March 2015 (Supplementary Figure 1). The choice of arterial access according
Discussion
The main findings of the present study are:
- (1)
TRA may reduce in-hospital bleedings in patients undergoing percutaneous treatment of ULM, without increasing the rate of adverse cardiovascular events at follow-up.
- (2)
TRA can be safely chosen in the treatment of ULM with second-generation DES and could potentially provide some benefits through the reduction of the acute-phase bleedings.
TRA has been demonstrated to reduce mortality compared with TFA in patients undergoing PCI, mainly due to a reduction of
Acknowledgment
Authors' contributions: Drs. Gili and D'Ascenzo helped in conception and design of the study, data analysis, interpretation of data analysis, manuscript draft, and manuscript review; Drs. Di Summa, Cerrato, Chieffo, and Boccuzzi in study conception and design and data analysis; Drs. Conrotto, Montefusco, Ugo, Omedé, Kawamoto, Tomassini, and Pavani in interpretation of data analysis and manuscript critical review; Drs. Varbella, Garbo, D'Amico, Zoccai, Moretti, Escaned, Chieffo, and Gaita in
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Acute kidney injury after radial or femoral artery access in ST-segment elevation myocardial infarction: AKI-SAFARI
2021, American Heart JournalCitation Excerpt :Within that cohort the 4 observational studies—all single center—found a 48% reduction in the incidence of AKI with RA.20,28,30,33 Whereas, the 5 retrospective studies that employed propensity score matching to reduce the risk of selection bias found RA to reduce the risk of AKI by 36% (OR: 0.64, 95% CI: 0.53-0.77).14,15,19,31,32 Notably, in both the observational and propensity-matched studies, the impact of RA was inversely proportional to the number of centers included in the study (Supplementary Table I).
Transradial Versus Transfemoral Access for Percutaneous Coronary Intervention of Unprotected Left Main Coronary Artery Stenosis: A Systematic Review and Meta-Analysis
2019, Cardiovascular Revascularization MedicineCitation Excerpt :All of the studies included were non randomized studies. Studies by Gili et al. and Chung et al. reported both unadjusted and propensity-adjusted data and only propensity-adjusted data were included in the final analysis [11,13]. Two of the studies included were conducted in Canada, two in Italy, and others in UK, China, Korea, and Taiwan.
Percutaneous coronary intervention outcomes in left main and multivessel disease: Navigating the patent minefield
2021, Catheterization and Cardiovascular InterventionsComparison of acute kidney injury with radial vs. femoral access for patients undergoing coronary catheterization: An updated meta‑analysis of 46,816 patients
2020, Experimental and Therapeutic MedicineLeft main percutaneous coronary intervention—Radial versus femoral access: A systematic analysis
2020, Catheterization and Cardiovascular Interventions
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