Jing Hu1, Xiangna Cai2, Xin Wang1, Lan Chen1, Duanmin Xu1, Jilin Li1. 1. Department of Cardiology, First Affliated Hospital of Shantou University Medical College Shantou City, Guangdong Province, China. 2. Department of Plastic Surgeon, First Affliated Hospital of Shantou University Medical College Shantou City, Guangdong Province, China.
Abstract
BACKGROUND: Transradial approach PCI reduces vascular complications compared with a transfemoral approach (TFA). TRA-PCI failure has been reported in 5-10% of cases. Reported studies showed that age > 75 years, previous CABG, short stature, female sex, and cardiogenic shock were independent predictors of TRA-PCI failure. However, related risk factors and causes of TRA-PCI failure are not well characterized, especially among Asians. OBJECTIVES: To explore the risk factors and causes of transfemoral approach (TRA)-PCI failure in Chaoshan area. METHODS: We retrospectively analyzed our databases for all patients who underwent TRA-PCI from January 2011 to June 2014 in the First Affiliated Hospital of Shantou University Medical College. Univariate and multivariate analyses were performed to determine independent risk factors of TRA-PCI failure and the causes of TRA-PCI failure. RESULTS: A total of 1,276 patients underwent TRA-PCI. From univariate analyses, patients in the TRA-PCI failure group were significantly in women, and more likely to be age > 75 years compared with TRA-PCI success group. Besides, patients in the TRA-PCI failure group were significantly more likely to suffer from left main coronary disease, more heparin dose, longer fluoroscopy time, and more PCI procedural failure compared with the TRA-PCI successful group. From multivariate analysis, female and age > 75 years were independent predictors of TRA-PCI failure. The causes of TRA-PCI failure included unsuccessful radial artery puncture in 34, vascular anomaly in 54, and the problems of guide catheter and guide wire in 26 patients. CONCLUSIONS: Being female and age > 75 years were independent risk factors of TRA-PCI failure. TRA-PCI failures indicated more possibility to suffer from left main coronary disease. The causes of TRA-PCI failure were complicated, among of those vascular abnormalities was an important factor.
BACKGROUND: Transradial approach PCI reduces vascular complications compared with a transfemoral approach (TFA). TRA-PCI failure has been reported in 5-10% of cases. Reported studies showed that age > 75 years, previous CABG, short stature, female sex, and cardiogenic shock were independent predictors of TRA-PCI failure. However, related risk factors and causes of TRA-PCI failure are not well characterized, especially among Asians. OBJECTIVES: To explore the risk factors and causes of transfemoral approach (TRA)-PCI failure in Chaoshan area. METHODS: We retrospectively analyzed our databases for all patients who underwent TRA-PCI from January 2011 to June 2014 in the First Affiliated Hospital of Shantou University Medical College. Univariate and multivariate analyses were performed to determine independent risk factors of TRA-PCI failure and the causes of TRA-PCI failure. RESULTS: A total of 1,276 patients underwent TRA-PCI. From univariate analyses, patients in the TRA-PCI failure group were significantly in women, and more likely to be age > 75 years compared with TRA-PCI success group. Besides, patients in the TRA-PCI failure group were significantly more likely to suffer from left main coronary disease, more heparin dose, longer fluoroscopy time, and more PCI procedural failure compared with the TRA-PCI successful group. From multivariate analysis, female and age > 75 years were independent predictors of TRA-PCI failure. The causes of TRA-PCI failure included unsuccessful radial artery puncture in 34, vascular anomaly in 54, and the problems of guide catheter and guide wire in 26 patients. CONCLUSIONS: Being female and age > 75 years were independent risk factors of TRA-PCI failure. TRA-PCI failures indicated more possibility to suffer from left main coronary disease. The causes of TRA-PCI failure were complicated, among of those vascular abnormalities was an important factor.
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