Treating total occlusions, complex bifurcations, grossly calcified lesions or left main lesions via transradial approach is associated with significant reduction in access-site bleeding or vascular complications vs transfemoral approach. This kind of procedures have been typically excluded from studies randomizing patients to transradial vs transfemoral approach. The COLOR study used the transradial bore-guiding catheter Glidesheath...
Courtesy of Dr. Carlos Fava. One of the characteristics of chronic total occlusion (CTO) is the use of two access routes: femoral and radial. The radial approach is safer, but it has not been thoroughly analyzed in this type of PCI. The study looked at 3709 patients undergoing left main percutaneous coronary intervention (PCI) for...
The transradial approach is being increasingly adopted as preferred access site, since it is more comfortable for patients, reduces vascular and bleeding complications, is cost effective and reduces mortality in high risk patients. This has created concern about the fact that operators and institutions could become unfamiliar with the transfemoral approach. The aim of...
Courtesy of Dr. Carlos Fava. The femoral approach has been the gold standard for the transcatheter aortic valve replacement procedure (TAVR); however, it is anatomically unsuitable for an important number of patients, and these require a different approach. At present, there is little evidence in support of the transapical or transaortic access sites as...
Dear Colleague, We are reaching out to ask you about your femoral access practices. A large proportion of angiographic and interventional procedures are performed via the femoral approach. We have noticed significant variability in the access technique. Some operators prefer micropuncture, others are adamant about using ultrasound whereas other interventionists feel comfortable with angiographic guidance....
Original Title: Radial vs femoral access for coronary interventions across the entire spectrum of patients with coronary artery disease: a meta-analysis of randomized trials. Reference: Ferrante G et al. J Am Coll Cardiol Intv. 2016; Epub ahead of print. Regardless the type of coronary syndrome, the transradial approach results in lower mortality and complications...
Original Title: The Benefits Conferred by Radial Access for Cardiac Catheterization Are Offset by a Paradoxical Increase in the Rate of Vascular Access Site Complications with Femoral Access: The Campeau Radial Paradox. Reference: Lorenzo Azzalini et al. J Am Coll Cardiol Intv. 2015, ONLINE FIRST. The aim of this study was to assess whether the benefit of the radial access...
Original title: Factors associated with vascular complications in patients undergoing balloon-expandable transfemoral transcatheter aortic valve replacement via open versus percutaneous approaches. Reference: Kadakia MB et al. Circ Cardiovasc Interv. 2014; Epub ahead of print. This retrospective study included 331 patients undergoing transfemoral TAVR in one center between 2007 and 2013. 64% of the population were treated with...
Original title: Full conversion from transfemoral to transradial approach for percutaneous coronary interventions results in a similar success rate and a rapid reduction of in-hospital cardiac and vascular major events. Reference: Vincent Dangoisse et al. EuroIntervention 2013;9:345-352. Although the transfemoral approach has clear disadvantages when it comes to bleeding complications, it continues to be the preferred approach<a href="https://solaci.org/en/2013/08/21/n-3536/" title="Read more" >...
TAVR has been shown beneficial in patients across the risk spectrum. The PARTNER 2 SAPIEN 3 (P2S3i) study on intermediate risk patients was the first to show TAVR superiority vs SAVR when using the transfemoral approach. SAVR durability has been shown in different analysis but, except for a few reports, TAVR durability at long term...