Transradial access(TRA)is a safe and comfortable approach and the preferred access for percutaneous coronary intervention.However,TRA is not widely used for peripheral interventions.Currently,there is a lack of data o...Transradial access(TRA)is a safe and comfortable approach and the preferred access for percutaneous coronary intervention.However,TRA is not widely used for peripheral interventions.Currently,there is a lack of data on patient selection,appropriate medical devices,complication prevention,and TRA adoption.Therefore,the Chinese Society of Interventional Oncology of the China Anti-Cancer Association organized nationwide experts to establish a Working Group of China Expert Consensus on TRA in percutaneous peripheral interventions in 2022,and jointly formulated this consensus to better promote the application of TRA in peripheral interventions to guide clinicians on patient selection,technical recommendations,and physician training.This consensus mainly focuses on the current situation,advantages and limitations of TRA in peripheral interventions,anatomical characteristics of the radial artery,patient selection,technical aspects,prevention and management of complications,radiation dose,and learning curve.A consensus was reached through a literature evaluation and by referring to the opinions of the expert group.展开更多
Objectives: To evaluate the feasibility, efficiency, and safety of the transradial approach(TRA) for cerebral angiography versus the transfemoral approach(TFA) in patients.Methods: In this trial, 2314 patients underwe...Objectives: To evaluate the feasibility, efficiency, and safety of the transradial approach(TRA) for cerebral angiography versus the transfemoral approach(TFA) in patients.Methods: In this trial, 2314 patients underwent cerebral angiography, with 1085 patients undergoing the procedure via radial access and 1229 via transfemoral access. The arterial puncture time, operation success rate,oppression time on puncture points, local vascular complication incidence(including bleeding, hematoma, and pseudoaneurysm), deep venous thrombosis of lower limbs(DVT), and bradycardia/hypotension were observed and compared between the two groups.Results: Of the patients who underwent cerebral angiography via radial access, the procedure was successful in1070 patients;compared with 1219 patients with transfemoral access, there was no significant difference(P > 0.05) in the success rate or the arterial puncture time. Radial access patients were less likely to present with oppression time on puncture points, local vascular complications, DVT, and bradycardia/hypotension compared with femoral access patients.Conclusions: For patients undergoing cerebral angiography, radial and femoral approaches are both safe and effective. However, the lower rate of local vascular complications may be a reason to use the radial approach.展开更多
Objective To compare hospital costs and clinical outcomes between transradial intervention （TRI） and transfemoral intervention （TFI） in elderly patients aged over 65 years. Methods We identified 1229 patients ag...Objective To compare hospital costs and clinical outcomes between transradial intervention （TRI） and transfemoral intervention （TFI） in elderly patients aged over 65 years. Methods We identified 1229 patients aged over 65 years who underwent percutaneous coronary intervention （PCI） in Fuwai Hospital, Beijing, China, between January 1 and December 31, 2010. Total hospital costs and in-hospital outcomes were compared between TRI and TFI. An inverse probability weighting （IPW） model was introduced to control potential biases. Results Patients who underwent TRI were younger, less often female, more likely to receive PCI for single-vessel lesions, and less likely to undergo the procedure for ostial lesions. TRI was associated with a cost saving of CNY7495 （95%CI： CNY4419-10 420）. Such differences were mainly driven by lower PCI-related costs. TRI patients had shorter length of stay （1.9 days, 95%CI： 1.1-2.7 days）, shorter post-procedural stay （0.7 days, 95%CI： 0.3-1.1 days）, and fewer major adverse cardiac events （adjusted odds ratio = 0.47, 95%CI： 0.31-0.73）. There was no statistical significance in the incidence of post-PCI bleeding between TRI and TFI （P〉0.05）. Such differences remained consistent in clinically relevant subgroups of acute myocardial infarction, acute coronary syndrome, and stable angina. Conclusion The use of TRI in patients aged over 65 years was associated with significantly reduced hospital costs and more favorable clinical outcomes.展开更多
Background Transradial coronary intervention has been widely used because of its effects in lowering the incidence of complications in vascular access site and improving patient satisfaction compared to the femoral ap...Background Transradial coronary intervention has been widely used because of its effects in lowering the incidence of complications in vascular access site and improving patient satisfaction compared to the femoral approach. This study aimed to investigate the safety and feasibility of transradial approach for primary percutaneous coronary intervention （PCI） in elderly patients with acute myocardial infarction （AMI）. Methods A total of 103 consecutive elderly patients Cage 〉65 years） who were diagnosed as having AMI were indicated for PCI. Among them, 57 patients received primary PCI via the transradial approach （transradial intervention, TRI group）, and 46 underwent primary PCI via the transfemoral approach （transfemoral intervention, TFI group）. The success rate of puncture, puncture time, cannulation time, repeffusion time, the total time for PCI, the success rate of PCI, the use rates of temporary pacemaker and intra-aortic balloon pump （IABP）, and the total length of hospital stay of the patients in the two groups were compared. After the procedure, vascular access site complications and major adverse cardiovascular events （MACE） in the two groups in one month were observed. Results The success rates of puncture （98.2% vs 100.0%） and PCI （96.5% vs 95.7%） for the patients in the TRI and TFI groups were not statistically significant （P〉0.05）. The puncture time （（2.4±1.1） vs （2.0±0.9） minutes）, cannulation time （（2.7±0.5） vs （2.6±0.5） minutes）, reperfusion time （（16.2±4.5） vs （15.4±3.6） minutes）, total time of the procedure （（44.1±6.8） vs （41.2±5.7） minutes）, use rates of temporary pacemaker （1.8% vs 2.2%） and IABP （0 vs 2.2%） in the two groups were not statistically significant （P〉0.05）, but the hospital stay of the TFI group was longer than that of the TRI group （（10.1±4.6） vs （7.2±2..6） days, P〈0.01）. A radial occlusion was observed in the TRI group, but no ischemic syndrome in hand展开更多
Background A comparison of efficacy and safety between transradial and transfemoral approach for percutaneous coronary intervention （PCI） in bifurcations has not been done. This study evaluated feasibility of transr...Background A comparison of efficacy and safety between transradial and transfemoral approach for percutaneous coronary intervention （PCI） in bifurcations has not been done. This study evaluated feasibility of transradial PCI （TRI） and compared the immediate and followup results with transfemoral PCI （TFI） in bifurcations. Methods One hundred and thirty-four consecutive patients with bifurcations were treated with PCI in our hospital from April 2004 to October 2005. Of these, there were 60 patients （88 lesions） in TRI group and 74 patients （101 lesions） in TFI group. Bifurcations type was classified according to the Institut Cardiovasculaire Paris Sud Classification. Results TRI group had smaller stent diameter （（3.06±0.37） mm vs （3.18±0.35） mm, P=0.023） and postprocedural in-stent minimum lumen diameter （（2.62±0.37） mm vs （2.74±0.41） mm, P=0.029） than TFI, but there were not significant differences in in-stent subacute thrombosis rate （0% vs 1.0%, P=0.349）, target lesion revascularization （TLR） （0% vs 1.0%, P=0.349） following procedure and thrombosis （2.3% vs 1.0%, P=0.482）, in-stent restenosis （12.5% vs 10.9%, P=0.731）, in-segment restenosis （17.0% vs 14.9%, P=0.681）, TLR （10.2% vs 13.9%, P=0.446） and TLR-free cumulative survival rate （89.8% vs 86.1%, P=0.787） at seven months followup. No death was reported in the two groups. Conclusion Transradial intervention is feasible and appears to be as effective and safe as transfemoral PCI in treatment of true bifurcational lesions.展开更多
The use of intense anticoagulation and antiplatelet therapy in acute myocardial infarction （AMI）potentially increases the risk of bleeding complications during percutaneous coronary intervention （PCI） via the tran...The use of intense anticoagulation and antiplatelet therapy in acute myocardial infarction （AMI）potentially increases the risk of bleeding complications during percutaneous coronary intervention （PCI） via the transfemoral approach. Recently, the transradial access has been increasingly employed as an alternative means for diagnostic and interventional procedures. Low incidence of vascular access site bleeding complications suggests the transradial approach as a safe alternative to the femoral technique in AMI, particularly under an aggressive anticoagulation/antiplatelet regimen.Nevertheless, the safety and feasibility of employing the transradial approach for primary PCI in AMI has not been thoroughly investigated so far.展开更多
文摘Transradial access(TRA)is a safe and comfortable approach and the preferred access for percutaneous coronary intervention.However,TRA is not widely used for peripheral interventions.Currently,there is a lack of data on patient selection,appropriate medical devices,complication prevention,and TRA adoption.Therefore,the Chinese Society of Interventional Oncology of the China Anti-Cancer Association organized nationwide experts to establish a Working Group of China Expert Consensus on TRA in percutaneous peripheral interventions in 2022,and jointly formulated this consensus to better promote the application of TRA in peripheral interventions to guide clinicians on patient selection,technical recommendations,and physician training.This consensus mainly focuses on the current situation,advantages and limitations of TRA in peripheral interventions,anatomical characteristics of the radial artery,patient selection,technical aspects,prevention and management of complications,radiation dose,and learning curve.A consensus was reached through a literature evaluation and by referring to the opinions of the expert group.
文摘Objectives: To evaluate the feasibility, efficiency, and safety of the transradial approach(TRA) for cerebral angiography versus the transfemoral approach(TFA) in patients.Methods: In this trial, 2314 patients underwent cerebral angiography, with 1085 patients undergoing the procedure via radial access and 1229 via transfemoral access. The arterial puncture time, operation success rate,oppression time on puncture points, local vascular complication incidence(including bleeding, hematoma, and pseudoaneurysm), deep venous thrombosis of lower limbs(DVT), and bradycardia/hypotension were observed and compared between the two groups.Results: Of the patients who underwent cerebral angiography via radial access, the procedure was successful in1070 patients;compared with 1219 patients with transfemoral access, there was no significant difference(P > 0.05) in the success rate or the arterial puncture time. Radial access patients were less likely to present with oppression time on puncture points, local vascular complications, DVT, and bradycardia/hypotension compared with femoral access patients.Conclusions: For patients undergoing cerebral angiography, radial and femoral approaches are both safe and effective. However, the lower rate of local vascular complications may be a reason to use the radial approach.
文摘Objective To compare hospital costs and clinical outcomes between transradial intervention （TRI） and transfemoral intervention （TFI） in elderly patients aged over 65 years. Methods We identified 1229 patients aged over 65 years who underwent percutaneous coronary intervention （PCI） in Fuwai Hospital, Beijing, China, between January 1 and December 31, 2010. Total hospital costs and in-hospital outcomes were compared between TRI and TFI. An inverse probability weighting （IPW） model was introduced to control potential biases. Results Patients who underwent TRI were younger, less often female, more likely to receive PCI for single-vessel lesions, and less likely to undergo the procedure for ostial lesions. TRI was associated with a cost saving of CNY7495 （95%CI： CNY4419-10 420）. Such differences were mainly driven by lower PCI-related costs. TRI patients had shorter length of stay （1.9 days, 95%CI： 1.1-2.7 days）, shorter post-procedural stay （0.7 days, 95%CI： 0.3-1.1 days）, and fewer major adverse cardiac events （adjusted odds ratio = 0.47, 95%CI： 0.31-0.73）. There was no statistical significance in the incidence of post-PCI bleeding between TRI and TFI （P〉0.05）. Such differences remained consistent in clinically relevant subgroups of acute myocardial infarction, acute coronary syndrome, and stable angina. Conclusion The use of TRI in patients aged over 65 years was associated with significantly reduced hospital costs and more favorable clinical outcomes.
文摘Background Transradial coronary intervention has been widely used because of its effects in lowering the incidence of complications in vascular access site and improving patient satisfaction compared to the femoral approach. This study aimed to investigate the safety and feasibility of transradial approach for primary percutaneous coronary intervention （PCI） in elderly patients with acute myocardial infarction （AMI）. Methods A total of 103 consecutive elderly patients Cage 〉65 years） who were diagnosed as having AMI were indicated for PCI. Among them, 57 patients received primary PCI via the transradial approach （transradial intervention, TRI group）, and 46 underwent primary PCI via the transfemoral approach （transfemoral intervention, TFI group）. The success rate of puncture, puncture time, cannulation time, repeffusion time, the total time for PCI, the success rate of PCI, the use rates of temporary pacemaker and intra-aortic balloon pump （IABP）, and the total length of hospital stay of the patients in the two groups were compared. After the procedure, vascular access site complications and major adverse cardiovascular events （MACE） in the two groups in one month were observed. Results The success rates of puncture （98.2% vs 100.0%） and PCI （96.5% vs 95.7%） for the patients in the TRI and TFI groups were not statistically significant （P〉0.05）. The puncture time （（2.4±1.1） vs （2.0±0.9） minutes）, cannulation time （（2.7±0.5） vs （2.6±0.5） minutes）, reperfusion time （（16.2±4.5） vs （15.4±3.6） minutes）, total time of the procedure （（44.1±6.8） vs （41.2±5.7） minutes）, use rates of temporary pacemaker （1.8% vs 2.2%） and IABP （0 vs 2.2%） in the two groups were not statistically significant （P〉0.05）, but the hospital stay of the TFI group was longer than that of the TRI group （（10.1±4.6） vs （7.2±2..6） days, P〈0.01）. A radial occlusion was observed in the TRI group, but no ischemic syndrome in hand
文摘Background A comparison of efficacy and safety between transradial and transfemoral approach for percutaneous coronary intervention （PCI） in bifurcations has not been done. This study evaluated feasibility of transradial PCI （TRI） and compared the immediate and followup results with transfemoral PCI （TFI） in bifurcations. Methods One hundred and thirty-four consecutive patients with bifurcations were treated with PCI in our hospital from April 2004 to October 2005. Of these, there were 60 patients （88 lesions） in TRI group and 74 patients （101 lesions） in TFI group. Bifurcations type was classified according to the Institut Cardiovasculaire Paris Sud Classification. Results TRI group had smaller stent diameter （（3.06±0.37） mm vs （3.18±0.35） mm, P=0.023） and postprocedural in-stent minimum lumen diameter （（2.62±0.37） mm vs （2.74±0.41） mm, P=0.029） than TFI, but there were not significant differences in in-stent subacute thrombosis rate （0% vs 1.0%, P=0.349）, target lesion revascularization （TLR） （0% vs 1.0%, P=0.349） following procedure and thrombosis （2.3% vs 1.0%, P=0.482）, in-stent restenosis （12.5% vs 10.9%, P=0.731）, in-segment restenosis （17.0% vs 14.9%, P=0.681）, TLR （10.2% vs 13.9%, P=0.446） and TLR-free cumulative survival rate （89.8% vs 86.1%, P=0.787） at seven months followup. No death was reported in the two groups. Conclusion Transradial intervention is feasible and appears to be as effective and safe as transfemoral PCI in treatment of true bifurcational lesions.
文摘The use of intense anticoagulation and antiplatelet therapy in acute myocardial infarction （AMI）potentially increases the risk of bleeding complications during percutaneous coronary intervention （PCI） via the transfemoral approach. Recently, the transradial access has been increasingly employed as an alternative means for diagnostic and interventional procedures. Low incidence of vascular access site bleeding complications suggests the transradial approach as a safe alternative to the femoral technique in AMI, particularly under an aggressive anticoagulation/antiplatelet regimen.Nevertheless, the safety and feasibility of employing the transradial approach for primary PCI in AMI has not been thoroughly investigated so far.
