Stenting in acute coronary syndromes: a comparison of radial versus femoral access sites
Objectives. The purpose of the present study was to compare the radial approach with the femoral approach for coronary stenting in patients with acute coronary syndromes. Background. Aggressive anticoagulation in patients with acute coronary syndromes increases the risk of femoral vascular complicat...
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| Veröffentlicht in: | Journal of the American College of Cardiology 1998-09, Vol.32 (3), p.572-576 |
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| creator | Mann, Tift Cubeddu, Gabriela Bowen, Josie Schneider, Joel E Arrowood, Michael Newman, William N Zellinger, Michael J Rose, Gregory C |
| description | Objectives. The purpose of the present study was to compare the radial approach with the femoral approach for coronary stenting in patients with acute coronary syndromes.
Background. Aggressive anticoagulation in patients with acute coronary syndromes increases the risk of femoral vascular complications. The transradial approach has the potential to significantly reduce the incidence of access site bleeding complications in this group of patients.
Methods. One hundred forty-two patients with acute coronary syndromes undergoing coronary stenting were prospectively randomized to have their procedure performed from either the radial or femoral access site and the results compared.
Results. Nine of 74 patients randomized to the radial group crossed over to the femoral group (6 negative Allen tests, 3 access failures). Patient demographics were the same in both groups. Primary success was identical: 96% radial, 96% femoral, ns. There were no procedural myocardial infarctions or deaths, and no patient was referred for emergency bypass surgery. There were no access site bleeding complications in the radial group as opposed to 3 (4%) in the femoral group, p < 0.01. Postprocedure length of stay, days (1.4 ± 0.2 radial vs. 2.3 ± 0.4 femoral, p < 0.01) as well as total hospital length of stay (3.0 ± 0.3 radial vs. 4.5 ± 0.5 femoral, p < 0.01) were significantly reduced in the radial group. Total hospital charge was also significantly lower in the radial group ($20,476 ± 811 radial versus $23,389 ± 1,180 femoral, p < 0.01).
Conclusion. Coronary stenting from the radial approach is efficacious in patients with acute coronary syndromes. Access site bleeding complications are less, and early ambulation results in a shorter hospital length of stay. There was a 15% reduction in total hospital charge in the radial group. |
| doi_str_mv | 10.1016/S0735-1097(98)00288-5 |
| format | Article |
| fullrecord | <record><control><sourceid>proquest_cross</sourceid><recordid>TN_cdi_proquest_miscellaneous_73912829</recordid><sourceformat>XML</sourceformat><sourcesystem>PC</sourcesystem><els_id>S0735109798002885</els_id><sourcerecordid>73912829</sourcerecordid><originalsourceid>FETCH-LOGICAL-c489t-58c9265eef1513e193a2c91d2d1976f3a2d1d2ab47292966e5ba396e00aae66f3</originalsourceid><addsrcrecordid>eNqFkMGKFDEQhoMo6-zqIyzkIKKH1iQ96U55EVlcFRY8rIK3UJOulkh3Mqa6F_btze4Mc_UU_tRXldQnxKVW77TS3ftb1be20Qr6N-DeKmWca-wTsdHWuqa10D8VmxPyXJwz_1FKdU7DmTiDfqu3YDfi1-1CaYnpt4xJYlgXkiGXnLDcS75PQ8kz8QeJ9XbeY4mck8yjLDhEnOQdFV5ZjjTnUiOGQMyS40L8QjwbcWJ6eTwvxM_rzz-uvjY33798u_p004Stg6WxLoDpLNGorW5JQ4smgB7MoKHvxpqGGnC37Q0Y6DqyO2yhI6UQqavAhXh9mLsv-e9KvPg5cqBpwkR5Zd-3oI0zUEF7AEPJzIVGvy9xrnt6rfyDUf9o1D_o8uD8o1Fva9_l8YF1N9Nw6joqrPVXxzpywGksmELkE2bavjVWVezjAaMq4y5S8RwipUBDLBQWP-T4n4_8A9gUkvQ</addsrcrecordid><sourcetype>Aggregation Database</sourcetype><iscdi>true</iscdi><recordtype>article</recordtype><pqid>73912829</pqid></control><display><type>article</type><title>Stenting in acute coronary syndromes: a comparison of radial versus femoral access sites</title><source>MEDLINE</source><source>Elsevier ScienceDirect Journals Complete</source><source>Elektronische Zeitschriftenbibliothek - Frei zugängliche E-Journals</source><source>Alma/SFX Local Collection</source><creator>Mann, Tift ; Cubeddu, Gabriela ; Bowen, Josie ; Schneider, Joel E ; Arrowood, Michael ; Newman, William N ; Zellinger, Michael J ; Rose, Gregory C</creator><creatorcontrib>Mann, Tift ; Cubeddu, Gabriela ; Bowen, Josie ; Schneider, Joel E ; Arrowood, Michael ; Newman, William N ; Zellinger, Michael J ; Rose, Gregory C</creatorcontrib><description>Objectives. The purpose of the present study was to compare the radial approach with the femoral approach for coronary stenting in patients with acute coronary syndromes.
Background. Aggressive anticoagulation in patients with acute coronary syndromes increases the risk of femoral vascular complications. The transradial approach has the potential to significantly reduce the incidence of access site bleeding complications in this group of patients.
Methods. One hundred forty-two patients with acute coronary syndromes undergoing coronary stenting were prospectively randomized to have their procedure performed from either the radial or femoral access site and the results compared.
Results. Nine of 74 patients randomized to the radial group crossed over to the femoral group (6 negative Allen tests, 3 access failures). Patient demographics were the same in both groups. Primary success was identical: 96% radial, 96% femoral, ns. There were no procedural myocardial infarctions or deaths, and no patient was referred for emergency bypass surgery. There were no access site bleeding complications in the radial group as opposed to 3 (4%) in the femoral group, p < 0.01. Postprocedure length of stay, days (1.4 ± 0.2 radial vs. 2.3 ± 0.4 femoral, p < 0.01) as well as total hospital length of stay (3.0 ± 0.3 radial vs. 4.5 ± 0.5 femoral, p < 0.01) were significantly reduced in the radial group. Total hospital charge was also significantly lower in the radial group ($20,476 ± 811 radial versus $23,389 ± 1,180 femoral, p < 0.01).
Conclusion. Coronary stenting from the radial approach is efficacious in patients with acute coronary syndromes. Access site bleeding complications are less, and early ambulation results in a shorter hospital length of stay. There was a 15% reduction in total hospital charge in the radial group.</description><identifier>ISSN: 0735-1097</identifier><identifier>EISSN: 1558-3597</identifier><identifier>DOI: 10.1016/S0735-1097(98)00288-5</identifier><identifier>PMID: 9741495</identifier><identifier>CODEN: JACCDI</identifier><language>eng</language><publisher>New York, NY: Elsevier Inc</publisher><subject>Aged ; Angina, Unstable - therapy ; Angioplasty, Balloon, Coronary - instrumentation ; Anticoagulants - administration & dosage ; Anticoagulants - adverse effects ; Biological and medical sciences ; Diseases of the cardiovascular system ; Female ; Femoral Artery ; Hemorrhage - chemically induced ; Hemorrhage - prevention & control ; Humans ; Male ; Medical sciences ; Middle Aged ; Myocardial Infarction - therapy ; Radial Artery ; Radiotherapy. Instrumental treatment. Physiotherapy. Reeducation. Rehabilitation, orthophony, crenotherapy. Diet therapy and various other treatments (general aspects) ; Risk Factors ; Stents ; Treatment Outcome</subject><ispartof>Journal of the American College of Cardiology, 1998-09, Vol.32 (3), p.572-576</ispartof><rights>1998 American College of Cardiology</rights><rights>1998 INIST-CNRS</rights><lds50>peer_reviewed</lds50><oa>free_for_read</oa><woscitedreferencessubscribed>false</woscitedreferencessubscribed><citedby>FETCH-LOGICAL-c489t-58c9265eef1513e193a2c91d2d1976f3a2d1d2ab47292966e5ba396e00aae66f3</citedby><cites>FETCH-LOGICAL-c489t-58c9265eef1513e193a2c91d2d1976f3a2d1d2ab47292966e5ba396e00aae66f3</cites></display><links><openurl>$$Topenurl_article</openurl><openurlfulltext>$$Topenurlfull_article</openurlfulltext><thumbnail>$$Tsyndetics_thumb_exl</thumbnail><linktohtml>$$Uhttps://www.sciencedirect.com/science/article/pii/S0735109798002885$$EHTML$$P50$$Gelsevier$$Hfree_for_read</linktohtml><link.rule.ids>314,776,780,3537,27901,27902,65534</link.rule.ids><backlink>$$Uhttp://pascal-francis.inist.fr/vibad/index.php?action=getRecordDetail&idt=2373250$$DView record in Pascal Francis$$Hfree_for_read</backlink><backlink>$$Uhttps://www.ncbi.nlm.nih.gov/pubmed/9741495$$D View this record in MEDLINE/PubMed$$Hfree_for_read</backlink></links><search><creatorcontrib>Mann, Tift</creatorcontrib><creatorcontrib>Cubeddu, Gabriela</creatorcontrib><creatorcontrib>Bowen, Josie</creatorcontrib><creatorcontrib>Schneider, Joel E</creatorcontrib><creatorcontrib>Arrowood, Michael</creatorcontrib><creatorcontrib>Newman, William N</creatorcontrib><creatorcontrib>Zellinger, Michael J</creatorcontrib><creatorcontrib>Rose, Gregory C</creatorcontrib><title>Stenting in acute coronary syndromes: a comparison of radial versus femoral access sites</title><title>Journal of the American College of Cardiology</title><addtitle>J Am Coll Cardiol</addtitle><description>Objectives. The purpose of the present study was to compare the radial approach with the femoral approach for coronary stenting in patients with acute coronary syndromes.
Background. Aggressive anticoagulation in patients with acute coronary syndromes increases the risk of femoral vascular complications. The transradial approach has the potential to significantly reduce the incidence of access site bleeding complications in this group of patients.
Methods. One hundred forty-two patients with acute coronary syndromes undergoing coronary stenting were prospectively randomized to have their procedure performed from either the radial or femoral access site and the results compared.
Results. Nine of 74 patients randomized to the radial group crossed over to the femoral group (6 negative Allen tests, 3 access failures). Patient demographics were the same in both groups. Primary success was identical: 96% radial, 96% femoral, ns. There were no procedural myocardial infarctions or deaths, and no patient was referred for emergency bypass surgery. There were no access site bleeding complications in the radial group as opposed to 3 (4%) in the femoral group, p < 0.01. Postprocedure length of stay, days (1.4 ± 0.2 radial vs. 2.3 ± 0.4 femoral, p < 0.01) as well as total hospital length of stay (3.0 ± 0.3 radial vs. 4.5 ± 0.5 femoral, p < 0.01) were significantly reduced in the radial group. Total hospital charge was also significantly lower in the radial group ($20,476 ± 811 radial versus $23,389 ± 1,180 femoral, p < 0.01).
Conclusion. Coronary stenting from the radial approach is efficacious in patients with acute coronary syndromes. Access site bleeding complications are less, and early ambulation results in a shorter hospital length of stay. There was a 15% reduction in total hospital charge in the radial group.</description><subject>Aged</subject><subject>Angina, Unstable - therapy</subject><subject>Angioplasty, Balloon, Coronary - instrumentation</subject><subject>Anticoagulants - administration & dosage</subject><subject>Anticoagulants - adverse effects</subject><subject>Biological and medical sciences</subject><subject>Diseases of the cardiovascular system</subject><subject>Female</subject><subject>Femoral Artery</subject><subject>Hemorrhage - chemically induced</subject><subject>Hemorrhage - prevention & control</subject><subject>Humans</subject><subject>Male</subject><subject>Medical sciences</subject><subject>Middle Aged</subject><subject>Myocardial Infarction - therapy</subject><subject>Radial Artery</subject><subject>Radiotherapy. Instrumental treatment. Physiotherapy. Reeducation. Rehabilitation, orthophony, crenotherapy. Diet therapy and various other treatments (general aspects)</subject><subject>Risk Factors</subject><subject>Stents</subject><subject>Treatment Outcome</subject><issn>0735-1097</issn><issn>1558-3597</issn><fulltext>true</fulltext><rsrctype>article</rsrctype><creationdate>1998</creationdate><recordtype>article</recordtype><sourceid>EIF</sourceid><recordid>eNqFkMGKFDEQhoMo6-zqIyzkIKKH1iQ96U55EVlcFRY8rIK3UJOulkh3Mqa6F_btze4Mc_UU_tRXldQnxKVW77TS3ftb1be20Qr6N-DeKmWca-wTsdHWuqa10D8VmxPyXJwz_1FKdU7DmTiDfqu3YDfi1-1CaYnpt4xJYlgXkiGXnLDcS75PQ8kz8QeJ9XbeY4mck8yjLDhEnOQdFV5ZjjTnUiOGQMyS40L8QjwbcWJ6eTwvxM_rzz-uvjY33798u_p004Stg6WxLoDpLNGorW5JQ4smgB7MoKHvxpqGGnC37Q0Y6DqyO2yhI6UQqavAhXh9mLsv-e9KvPg5cqBpwkR5Zd-3oI0zUEF7AEPJzIVGvy9xrnt6rfyDUf9o1D_o8uD8o1Fva9_l8YF1N9Nw6joqrPVXxzpywGksmELkE2bavjVWVezjAaMq4y5S8RwipUBDLBQWP-T4n4_8A9gUkvQ</recordid><startdate>19980901</startdate><enddate>19980901</enddate><creator>Mann, Tift</creator><creator>Cubeddu, Gabriela</creator><creator>Bowen, Josie</creator><creator>Schneider, Joel E</creator><creator>Arrowood, Michael</creator><creator>Newman, William N</creator><creator>Zellinger, Michael J</creator><creator>Rose, Gregory C</creator><general>Elsevier Inc</general><general>Elsevier Science</general><scope>6I.</scope><scope>AAFTH</scope><scope>IQODW</scope><scope>CGR</scope><scope>CUY</scope><scope>CVF</scope><scope>ECM</scope><scope>EIF</scope><scope>NPM</scope><scope>AAYXX</scope><scope>CITATION</scope><scope>7X8</scope></search><sort><creationdate>19980901</creationdate><title>Stenting in acute coronary syndromes: a comparison of radial versus femoral access sites</title><author>Mann, Tift ; Cubeddu, Gabriela ; Bowen, Josie ; Schneider, Joel E ; Arrowood, Michael ; Newman, William N ; Zellinger, Michael J ; Rose, Gregory C</author></sort><facets><frbrtype>5</frbrtype><frbrgroupid>cdi_FETCH-LOGICAL-c489t-58c9265eef1513e193a2c91d2d1976f3a2d1d2ab47292966e5ba396e00aae66f3</frbrgroupid><rsrctype>articles</rsrctype><prefilter>articles</prefilter><language>eng</language><creationdate>1998</creationdate><topic>Aged</topic><topic>Angina, Unstable - therapy</topic><topic>Angioplasty, Balloon, Coronary - instrumentation</topic><topic>Anticoagulants - administration & dosage</topic><topic>Anticoagulants - adverse effects</topic><topic>Biological and medical sciences</topic><topic>Diseases of the cardiovascular system</topic><topic>Female</topic><topic>Femoral Artery</topic><topic>Hemorrhage - chemically induced</topic><topic>Hemorrhage - prevention & control</topic><topic>Humans</topic><topic>Male</topic><topic>Medical sciences</topic><topic>Middle Aged</topic><topic>Myocardial Infarction - therapy</topic><topic>Radial Artery</topic><topic>Radiotherapy. Instrumental treatment. Physiotherapy. Reeducation. Rehabilitation, orthophony, crenotherapy. Diet therapy and various other treatments (general aspects)</topic><topic>Risk Factors</topic><topic>Stents</topic><topic>Treatment Outcome</topic><toplevel>peer_reviewed</toplevel><toplevel>online_resources</toplevel><creatorcontrib>Mann, Tift</creatorcontrib><creatorcontrib>Cubeddu, Gabriela</creatorcontrib><creatorcontrib>Bowen, Josie</creatorcontrib><creatorcontrib>Schneider, Joel E</creatorcontrib><creatorcontrib>Arrowood, Michael</creatorcontrib><creatorcontrib>Newman, William N</creatorcontrib><creatorcontrib>Zellinger, Michael J</creatorcontrib><creatorcontrib>Rose, Gregory C</creatorcontrib><collection>ScienceDirect Open Access Titles</collection><collection>Elsevier:ScienceDirect:Open Access</collection><collection>Pascal-Francis</collection><collection>Medline</collection><collection>MEDLINE</collection><collection>MEDLINE (Ovid)</collection><collection>MEDLINE</collection><collection>MEDLINE</collection><collection>PubMed</collection><collection>CrossRef</collection><collection>MEDLINE - Academic</collection><jtitle>Journal of the American College of Cardiology</jtitle></facets><delivery><delcategory>Remote Search Resource</delcategory><fulltext>fulltext</fulltext></delivery><addata><au>Mann, Tift</au><au>Cubeddu, Gabriela</au><au>Bowen, Josie</au><au>Schneider, Joel E</au><au>Arrowood, Michael</au><au>Newman, William N</au><au>Zellinger, Michael J</au><au>Rose, Gregory C</au><format>journal</format><genre>article</genre><ristype>JOUR</ristype><atitle>Stenting in acute coronary syndromes: a comparison of radial versus femoral access sites</atitle><jtitle>Journal of the American College of Cardiology</jtitle><addtitle>J Am Coll Cardiol</addtitle><date>1998-09-01</date><risdate>1998</risdate><volume>32</volume><issue>3</issue><spage>572</spage><epage>576</epage><pages>572-576</pages><issn>0735-1097</issn><eissn>1558-3597</eissn><coden>JACCDI</coden><abstract>Objectives. The purpose of the present study was to compare the radial approach with the femoral approach for coronary stenting in patients with acute coronary syndromes.
Background. Aggressive anticoagulation in patients with acute coronary syndromes increases the risk of femoral vascular complications. The transradial approach has the potential to significantly reduce the incidence of access site bleeding complications in this group of patients.
Methods. One hundred forty-two patients with acute coronary syndromes undergoing coronary stenting were prospectively randomized to have their procedure performed from either the radial or femoral access site and the results compared.
Results. Nine of 74 patients randomized to the radial group crossed over to the femoral group (6 negative Allen tests, 3 access failures). Patient demographics were the same in both groups. Primary success was identical: 96% radial, 96% femoral, ns. There were no procedural myocardial infarctions or deaths, and no patient was referred for emergency bypass surgery. There were no access site bleeding complications in the radial group as opposed to 3 (4%) in the femoral group, p < 0.01. Postprocedure length of stay, days (1.4 ± 0.2 radial vs. 2.3 ± 0.4 femoral, p < 0.01) as well as total hospital length of stay (3.0 ± 0.3 radial vs. 4.5 ± 0.5 femoral, p < 0.01) were significantly reduced in the radial group. Total hospital charge was also significantly lower in the radial group ($20,476 ± 811 radial versus $23,389 ± 1,180 femoral, p < 0.01).
Conclusion. Coronary stenting from the radial approach is efficacious in patients with acute coronary syndromes. Access site bleeding complications are less, and early ambulation results in a shorter hospital length of stay. There was a 15% reduction in total hospital charge in the radial group.</abstract><cop>New York, NY</cop><pub>Elsevier Inc</pub><pmid>9741495</pmid><doi>10.1016/S0735-1097(98)00288-5</doi><tpages>5</tpages><oa>free_for_read</oa></addata></record> |
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| subjects | Aged Angina, Unstable - therapy Angioplasty, Balloon, Coronary - instrumentation Anticoagulants - administration & dosage Anticoagulants - adverse effects Biological and medical sciences Diseases of the cardiovascular system Female Femoral Artery Hemorrhage - chemically induced Hemorrhage - prevention & control Humans Male Medical sciences Middle Aged Myocardial Infarction - therapy Radial Artery Radiotherapy. Instrumental treatment. Physiotherapy. Reeducation. Rehabilitation, orthophony, crenotherapy. Diet therapy and various other treatments (general aspects) Risk Factors Stents Treatment Outcome |
| title | Stenting in acute coronary syndromes: a comparison of radial versus femoral access sites |
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