Radial versus femoral access for orally anticoagulated patients

Ziakas, Antonios; Koskinas, Konstantinos C.; Gavrilidis, Stavros; Giannoglou, George D.; Hadjimiltiades, Stavros; Gourassas, Ioannis; Theofilogiannakos, Efstratios K.; Economou, Fotios; Styliadis, Ioannis H.

doi:10.1002/ccd.22527

Cited by 56 publications

(32 citation statements)

References 71 publications

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“…1 Deviations from normal anatomy are not infrequent, occurring in 18.5% of 386 cadavers studied by McCormack et al 2 Unilateral abnormalities were more common than bilateral (24.5% and 6.3%, respectively). Similar findings have also been reported by Fujii et al and Ziakas et al 3,4 Rodriguez-Baeza et al have proposed 4 groups of anomalies: isolated persistence of the median artery; high origin of the ulnar artery; high origin of the radial artery, and duplication of the brachial artery, either with or without anastomosis at the cubital fossa. 5 The most common anomaly is a high origin of the radial artery, either from the brachial or axillary artery, and has been shown in 14.27% of cadaveric samples and 9.75% in angiographic examinations.…”

Section: Discussionsupporting

confidence: 85%

Weak Radial Artery Pulse : An Unusual Congenital Cause = النبض الضعيف في الشريان الكعبري : سبب خلقي غير عادي

Venugopalan¹,

Sivakumar²,

Ardley³

et al. 2012

SQUMJ

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Section: Discussionsupporting

confidence: 85%

Weak Radial Artery Pulse : An Unusual Congenital Cause = النبض الضعيف في الشريان الكعبري : سبب خلقي غير عادي

Venugopalan¹,

Sivakumar²,

Ardley³

et al. 2012

SQUMJ

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“…These thresholds are rather arbitrary and based on scant data. Of note, a new study of fully anticoagulated patients undergoing PCI from either the radial or femoral access site suggests a major advantage to the use of radial access regarding periprocedural bleeding (187). Overuse of parenteral vitamin K may make it difficult to re-establish an antithrombin effect following the procedure, therefore allowing the patient's INR to drift downward after stopping the medication is preferred.…”

Section: Patients Receiving Antiplatelet and Antithrombin Agentsmentioning

confidence: 97%

2012 American College of Cardiology Foundation/Society for Cardiovascular Angiography and Interventions Expert Consensus Document on Cardiac Catheterization Laboratory Standards Update

Bashore¹,

Balter²,

Barac³

et al. 2012

Journal of the American College of Cardiology

196

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“…On the other hand, a femoral approach with vascular closure device (Angioseal) was noninferior to a radial approach in reducing postcardiac procedure complications 17. However, studies have shown that patients with uninterrupted warfarin undergoing radial approach had less vascular complications 18,19…”

Section: Discussionmentioning

confidence: 99%

Predictors of common femoral artery access site complications in patients on oral anticoagulants and undergoing a coronary procedure

Shammas

Jones-Miller

et al. 2017

TCRM

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BackgroundIt is unclear whether patients on oral anticoagulants (OAC) undergoing a procedure using common femoral artery access have higher adverse events when compared to patients who are not anticoagulated at the time of the procedure.MethodsWe retrospectively reviewed data from consecutive patients who underwent a cardiac procedure at a tertiary medical center. Patients were considered (group A) fully or partially anticoagulated if they had an international normalized ratio (INR) ≥1.6 on the day of the procedure or were on warfarin or new OAC within 48 h and 24 h of the procedure, respectively. The nonanticoagulated group (group B) had an INR <1.6 or had stopped their warfarin and new OAC >48 h and >24 h preprocedure, respectively. The index primary end point of the study was defined as the composite end point of major bleeding, vascular complications, or cardiovascular-related death during index hospitalization. The 30-day primary end point was defined as the occurrence of the index primary end point and up to 30 days postprocedure.ResultsA total of 779 patients were included in this study. Of these patients, 27 (3.5%) patients were in group A. The index primary end point was met in 11/779 (1.4%) patients. The 30-day primary composite end point was met in 18/779 (2.3%) patients. There was no difference in the primary end point at index between group A (1/27 [3.7%]) and group B (10/752 [1.3%]; P=0.3155) and no difference in the 30-day primary composite end point between group A (2/27 [7.4%]) and group B (16/752 [2.1%]; P=0.1313). Multivariable analysis showed that a low creatinine clearance (odds ratio [OR] =0.56; P=0.0200) and underweight patients (<60 kg; OR =3.94; P=0.0300) were independent predictors of the 30-day primary composite end point but not oral anticoagulation (P=0.1500).ConclusionPatients on OAC did not have higher 30-day major adverse events than those who were not anticoagulated at index procedure.

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Radial versus femoral access for orally anticoagulated patients

Abstract: The radial access is as efficacious and safe as the femoral route for coronary angiography in fully anticoagulated patients, but is likely to result in fewer access-site complications in patients who also undergo PCI.

Cited by 56 publications

References 71 publications

Weak Radial Artery Pulse : An Unusual Congenital Cause = النبض الضعيف في الشريان الكعبري : سبب خلقي غير عادي

Weak Radial Artery Pulse : An Unusual Congenital Cause = النبض الضعيف في الشريان الكعبري : سبب خلقي غير عادي

2012 American College of Cardiology Foundation/Society for Cardiovascular Angiography and Interventions Expert Consensus Document on Cardiac Catheterization Laboratory Standards Update

Predictors of common femoral artery access site complications in patients on oral anticoagulants and undergoing a coronary procedure

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