Radial versus femoral access for rotational atherectomy: A UK observational study of 8622 patients

Watt, J., Austin, D., Mackay, D. , Nolan, J. and Oldroyd, K. G. (2017) Radial versus femoral access for rotational atherectomy: A UK observational study of 8622 patients. Circulation: Cardiovascular Interventions, 10(12), e005311. (doi:10.1161/CIRCINTERVENTIONS.117.005311) (PMID:29246910)

Watt, J., Austin, D., Mackay, D. , Nolan, J. and Oldroyd, K. G. (2017) Radial versus femoral access for rotational atherectomy: A UK observational study of 8622 patients. Circulation: Cardiovascular Interventions, 10(12), e005311. (doi:10.1161/CIRCINTERVENTIONS.117.005311) (PMID:29246910)

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Abstract

Background—Rotational atherectomy (RA) is an important interventional tool for heavily calcified coronary lesions. We compared the early clinical outcomes in patients undergoing RA using radial or femoral access. Methods and Results—We identified all patients in England and Wales who underwent RA between January 1, 2005, and March 31, 2014. Eight thousand six hundred twenty-two RA cases (3069 radial and 5553 femoral) were included in the analysis. The study primary outcome was 30-day mortality. Propensity scores were calculated to determine the factors associated with treatment assignment to radial or femoral access. Multivariable logistic regression analysis, using the calculated propensity scores, was performed. Thirty-day mortality was 2.2% in the radial and 2.3% in the femoral group (P=0.76). Radial access was associated with equivalent 30-day mortality (adjusted odds ratio [OR], 1.06; 95% confidence interval [CI], 0.77–1.46; P=0.71), procedural success (OR, 1.04; 95% CI, 0.84–1.29; P=0.73), major adverse cardiac and cerebrovascular events (OR, 1.05; 95% CI, 0.80–1.38; P=0.72), and net adverse clinical events (OR, 0.90; 95% CI, 0.71–1.15; P=0.41), but lower rates of in-hospital major bleeding (OR, 0.62; 95% CI, 0.40–0.98; P=0.04) and major access site complications (OR, 0.05; 95% CI, 0.01–0.38; P=0.004), compared with femoral access. Conclusions—In this large real-world study of patients undergoing RA, radial access was associated with equivalent 30-day mortality and procedural success, but reduced major bleeding and access site complications, compared with femoral access.

Item Type:Articles
Status:Published
Refereed:Yes
Glasgow Author(s) Enlighten ID:Oldroyd, Dr Keith and Mackay, Dr Daniel
Authors: Watt, J., Austin, D., Mackay, D., Nolan, J., and Oldroyd, K. G.
College/School:College of Medical Veterinary and Life Sciences > Institute of Cardiovascular and Medical Sciences
College of Medical Veterinary and Life Sciences > Institute of Health and Wellbeing > Public Health
Journal Name:Circulation: Cardiovascular Interventions
Publisher:American Heart Assocation
ISSN:1941-7640
ISSN (Online):1941-7632
Published Online:15 December 2017
Copyright Holders:Copyright © 2017 American Heart Association, Inc.
First Published:First published in Circulation: Cardiovascular Interventions 10(12):e005311
Publisher Policy:Reproduced in accordance with the copyright policy of the publisher.

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