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Predictors of Technical Failure in Transradial Coronary Angiography and Intervention

Monique Tröbs1, Stephan Achenbach1, Pia Maria Plank1

  • 1Department of Cardiology, Friedrich Alexander Universität Erlangen-Nürnberg (FAU), Erlangen, Germany.

The American Journal of Cardiology
|August 29, 2017
PubMed

Insights

Transradial access for heart procedures is often preferred but can fail. Female sex, older age, and shorter height are key predictors of transradial access failure, not ST-elevation myocardial infarction.

Area of Science:

  • Cardiology
  • Interventional Cardiology
  • Vascular Access

Background:

  • Transradial access is increasingly preferred for coronary angiography and intervention due to its benefits over the femoral approach.
  • However, transradial access can be technically challenging, and understanding failure predictors is crucial, particularly for patients with acute coronary syndromes.

Purpose of the Study:

  • To identify independent predictors of transradial access failure in a large cohort of patients undergoing coronary angiography or intervention.
  • To assess if ST-elevation myocardial infarction is associated with a higher rate of transradial access failure.

Main Methods:

  • Retrospective analysis of 13,095 consecutive patients undergoing attempted transradial access for coronary angiography or intervention.
  • Systematic review of angiograms and patient files to identify patient characteristics associated with access failure.
  • Multivariable logistic regression analysis to determine independent predictors of failure.

Main Results:

  • The overall transradial access failure rate was 6.8%.
  • Independent predictors of failure included female sex (OR 1.44), higher patient age (OR 1.01/year), and lower patient height (OR 0.98/cm).
  • Transradial access failure was not significantly more frequent in patients with ST-elevation myocardial infarction compared to other patients (8.1% vs 6.9%).

Conclusions:

  • Female sex, advanced age, and shorter stature are independent predictors of transradial access failure during coronary procedures.
  • The risk of transradial access failure is not significantly increased in patients with ST-elevation myocardial infarction.

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