Related Experiment Video

Updated: Jan 31, 2026

Interventional Diagnostic Procedure: A Practical Guide for the Assessment of Coronary Vascular Function
10:28

Interventional Diagnostic Procedure: A Practical Guide for the Assessment of Coronary Vascular Function

Published on: March 15, 2022

5.9K

Access Site and Outcomes for Unprotected Left Main Stem Percutaneous Coronary Intervention: An Analysis of the

Tim Kinnaird1, Richard Anderson2, Sean Gallagher2

  • 1Department of Cardiology, University Hospital of Wales, Cardiff, United Kingdom; Keele Cardiovascular Research Group, Institute of Applied Clinical Sciences, University of Keele, Stoke-on-Trent, United Kingdom.

JACC. Cardiovascular Interventions
|December 22, 2018
PubMed

Insights

Radial access (RA) is now the preferred arterial access site for unprotected left main stem percutaneous coronary intervention (LMS-PCI). RA use leads to shorter hospital stays and fewer vascular complications compared to femoral access (FA).

Area of Science:

  • Cardiovascular Interventions
  • Interventional Cardiology
  • Vascular Access Techniques

Background:

  • Arterial access site selection for unprotected left main stem percutaneous coronary intervention (LMS-PCI) remains poorly defined.
  • Understanding trends and outcomes associated with different access sites is crucial for optimizing patient care.

Purpose of the Study:

  • To analyze temporal trends, predictors, and outcomes of radial access (RA) versus femoral access (FA) for unprotected LMS-PCI.
  • To evaluate the impact of access site choice on procedural success, complications, and patient outcomes.

Main Methods:

  • Analysis of 19,482 unprotected LMS-PCI procedures from the British Cardiovascular Intervention Society PCI database (2007-2014).
  • Multivariate logistic regression to identify predictors of access site choice and its association with outcomes.
  • Propensity matching to compare outcomes between RA and FA groups.

Main Results:

  • Femoral access (FA) use decreased significantly from 77.7% in 2007 to 31.7% in 2014.
  • Radial access (RA) use was associated with shorter length of stay, higher same-day discharge rates, and reduced in-hospital complications (arterial complications, major bleeding, MACE).
  • RA use did not significantly impact 12-month mortality.

Conclusions:

  • Radial artery has become the predominant access site for unprotected LMS-PCI in contemporary practice.
  • RA use is linked to improved short-term outcomes, including reduced vascular complications and bleeding, compared to FA.
  • Further research may explore long-term outcomes and specific patient selection criteria for RA in complex LMS-PCI procedures.
Abstract

Keywords:
access site choiceaccess site complicationsbleedingleft main arterynational databasepercutaneous coronary intervention

More Related Videos

Development and Evaluation of 3D-Printed Cardiovascular Phantoms for Interventional Planning and Training09:57

Development and Evaluation of 3D-Printed Cardiovascular Phantoms for Interventional Planning and Training

Published on: January 18, 2021

4.6K
Echocardiographic Characterization of Left Ventricular Structure, Function, and Coronary Flow in Neonate Mice07:55

Echocardiographic Characterization of Left Ventricular Structure, Function, and Coronary Flow in Neonate Mice

Published on: April 7, 2022

3.7K

Related Concept Videos

Nursing Interventions I: Taxonomy of Nursing Interventions01:03

Nursing Interventions I: Taxonomy of Nursing Interventions

Nursing interventions are chosen as part of the planning process to achieve patient outcomes. Once nursing diagnoses are determined, the goals and outcomes are specified, then the nursing interventions are selected and individualized according to the patient's situation.
A nursing intervention is a treatment or action based on scientific concepts and knowledge from the nursing, behavioral, and physical sciences. Identifying and prioritizing nursing interventions based on the desired outcome...
3.9K
Nursing Interventions II: Selecting and Classifying the Nursing Interventions01:29

Nursing Interventions II: Selecting and Classifying the Nursing Interventions

Creating and executing a nursing diagnosis helps nurses plan care and guide patient, family, and community interventions. They are developed based on a patient's physical evaluation and support measuring the outcomes. It is not recommended to select random interventions throughout the planning process. Instead, consider the following six essential factors when choosing interventions:
3.3K
Community Based Intervention01:30

Community Based Intervention

Community-based interventions in mental health represent a paradigm shift from institution-centered care to treatments embedded within the fabric of local communities. By prioritizing inclusion and leveraging existing societal structures, this approach fosters a supportive environment conducive to addressing mental health challenges while promoting individual dignity and agency.
Foundations of Community Mental Health Programs
Central to the success of community-based interventions is the...
479
Operant Conditioning Intervention01:24

Operant Conditioning Intervention

Operant conditioning serves as a foundational principle in therapeutic interventions aimed at modifying maladaptive behaviors. Central to this approach is the notion that behaviors, both adaptive and maladaptive, are learned through reinforcement. By analyzing the environmental factors that reinforce problematic behaviors, clinicians can design interventions to weaken these reinforcements and replace maladaptive behaviors with healthier alternatives.
In operant conditioning, behaviors that are...
509
Heart Failure VII: Nursing Interventions01:30

Heart Failure VII: Nursing Interventions

The first step in nursing management of a patient with heart failure involves thoroughly assessing the patient's medical history.Subjective Data: Obtain the patient's medical history of coronary artery disease, hypertension, myocardial infarction, and symptoms like dyspnea, orthopnea, and paroxysmal nocturnal dyspnea.Objective Data: Conduct a physical examination to identify findings such as jugular vein distention, pulmonary crackles, tachycardia, murmurs, peripheral edema, and vital signs,...
500
Predicting Reaction Outcomes02:24

Predicting Reaction Outcomes

Kinetics describes the rate and path by which a reaction occurs. In contrast, thermodynamics deals with state functions and describes the properties, behavior, and components of a system. It is not concerned with the path taken by the process and cannot address the rate at which a reaction occurs. Although it does provide information about what can happen during a reaction process, it does not describe the detailed steps of what appears on an atomic or a molecular level. On the other hand,...
10.8K