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Impact of transradial coronary intervention on bleeding complications in octogenarians

Khalid Tammam1, Yuji Ikari2, Fuminobu Yoshimachi3

  • 1Cardiac Center of Excellence, International Medical Center, Jeddah, Saudi Arabia.

Cardiovascular Intervention and Therapeutics
|February 25, 2016
PubMed

Insights

Transradial intervention (TRI) significantly reduced bleeding complications in octogenarians undergoing percutaneous coronary intervention (PCI). This approach offers a safer alternative for elderly patients, potentially lowering mortality rates associated with bleeding events.

Area of Science:

  • Cardiology
  • Interventional Cardiology
  • Geriatric Medicine

Background:

  • Percutaneous coronary intervention (PCI) in elderly patients presents significant challenges due to high mortality and comorbidity rates.
  • Bleeding complications are a major concern following PCI in octogenarians, impacting patient outcomes.
  • The choice of vascular access strategy, transradial intervention (TRI) versus transfemoral intervention (TFI), may influence complication rates.

Purpose of the Study:

  • To evaluate the impact of transradial intervention (TRI) on bleeding complications in octogenarians undergoing PCI.
  • To compare bleeding rates and mortality between TRI and TFI in this specific elderly population.

Main Methods:

  • Retrospective analysis of 2530 PCI cases at a tertiary care center in Japan.
  • Focus on a cohort of 291 octogenarians (12% of total PCI cases).
  • Comparison of Bleeding Academic Research Consortium (BARC) major bleeding and 30-day all-cause mortality between TRI and TFI groups.

Main Results:

  • Major bleeding complications occurred in 7.6% of octogenarians, significantly lower with TRI (5.1%) compared to TFI (15.1%).
  • The 30-day mortality rate was substantially lower in patients without bleeding complications (4.9%) versus those with bleeding (31%).
  • TRI demonstrated a significantly lower bleeding complication rate than TFI in the octogenarian population.

Conclusions:

  • Transradial intervention (TRI) is associated with reduced major bleeding complications in octogenarians undergoing PCI compared to transfemoral intervention (TFI).
  • Minimizing bleeding complications in this high-risk group is crucial for improving 30-day mortality outcomes.
  • Octogenarians represent a patient subgroup that may particularly benefit from the transradial approach for PCI.

Keywords:
Bleeding complicationsElderlyPercutaneous coronary interventionTransradial intervention

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