TY - JOUR
T1 - Clinical Outcomes and Associations With Radial to Femoral Crossover in ST-Elevation Myocardial Infarction
AU - Balfe, Christopher
AU - Jacob, Benjamin
AU - Morad, Samir
AU - Elsayed, Amged
AU - Tan, Lok Yi Joyce
AU - Nelson, Edel
AU - AlBaghdadi, Ali
AU - Power, Aoife
AU - Twomey, David
AU - McDermott, Breda
AU - Ahern, Catriona
AU - Abbas, Syed Farhat
AU - Hennessy, Terence
AU - Ullah, Ihsan
AU - Arnous, Samer
AU - Kiernan, Thomas
N1 - Publisher Copyright:
© 2023 Elsevier Inc.
PY - 2023/8/1
Y1 - 2023/8/1
N2 - Radial access during primary percutaneous coronary intervention is associated with reduced mortality and major bleeding compared with femoral access and is the recommended access site. Nevertheless, failure to secure radial access may necessitate crossover to femoral access. This study aimed to identify the associations with crossover from radial to femoral access in all comers with ST-elevation myocardial infarction and to compare the clinical outcomes with those patients who did not require crossover. From 2016 to 2021, a total of 1,202 patients presented to our institute with ST-elevation myocardial infarction. Associations, clinical outcomes, and independent predictors of crossover from radial to femoral access were identified. From 1,202 patients, radial access was used in 1,138 patients (94.7%) and crossover to femoral access occurred in 64 patients (5.3%). Patients who required crossover to femoral access had higher rates of access site complications and longer length of stay in the hospital. Inpatient mortality was higher in the group requiring a crossover. This study identified 3 independent predictors of crossover from radial to femoral access in primary percutaneous coronary intervention: cardiogenic shock, cardiac arrest before arrival at the catheterization laboratory, and previous coronary artery bypass grafting. Biochemical infarct size and peak creatinine was also found to be higher in those requiring crossover. In conclusion, crossover in this study portended an increased rate of access site complications, greatly prolonged length of stay, and a significantly higher risk of death.
AB - Radial access during primary percutaneous coronary intervention is associated with reduced mortality and major bleeding compared with femoral access and is the recommended access site. Nevertheless, failure to secure radial access may necessitate crossover to femoral access. This study aimed to identify the associations with crossover from radial to femoral access in all comers with ST-elevation myocardial infarction and to compare the clinical outcomes with those patients who did not require crossover. From 2016 to 2021, a total of 1,202 patients presented to our institute with ST-elevation myocardial infarction. Associations, clinical outcomes, and independent predictors of crossover from radial to femoral access were identified. From 1,202 patients, radial access was used in 1,138 patients (94.7%) and crossover to femoral access occurred in 64 patients (5.3%). Patients who required crossover to femoral access had higher rates of access site complications and longer length of stay in the hospital. Inpatient mortality was higher in the group requiring a crossover. This study identified 3 independent predictors of crossover from radial to femoral access in primary percutaneous coronary intervention: cardiogenic shock, cardiac arrest before arrival at the catheterization laboratory, and previous coronary artery bypass grafting. Biochemical infarct size and peak creatinine was also found to be higher in those requiring crossover. In conclusion, crossover in this study portended an increased rate of access site complications, greatly prolonged length of stay, and a significantly higher risk of death.
UR - http://www.scopus.com/inward/record.url?scp=85161697219&partnerID=8YFLogxK
U2 - 10.1016/j.amjcard.2023.05.020
DO - 10.1016/j.amjcard.2023.05.020
M3 - Article
C2 - 37307779
AN - SCOPUS:85161697219
SN - 0002-9149
VL - 200
SP - 103
EP - 111
JO - American Journal of Cardiology
JF - American Journal of Cardiology
ER -