TY - JOUR
T1 - Transradial coronary stenting
T2 - Comparison with femoral access closed with an arterial suture device
AU - Mann, Tift
AU - Cowper, Patricia A.
AU - Peterson, Eric D.
AU - Cubeddu, Gabriela
AU - Bowen, Josie
AU - Giron, Luis
AU - Cantor, Warren J.
AU - Newman, William N.
AU - Schneider, Joel E.
AU - Jobe, R. Lee
AU - Zellinger, Michael J.
AU - Rose, Gregory C.
PY - 2000
Y1 - 2000
N2 - The purpose of this study was to determine if closure of the femoral artery access site using a percutaneous arterial suture device (Perclose, Menlo Park, CA) in patients undergoing coronary stenting can result in the same benefits as seen with radial artery access. A total of 218 consecutive patients underwent coronary stenting (109 femoral, 109 radial) by investigators experienced with each technique. The two groups were matched in terms of sex, age, clinical presentation (50% acute), number of vessels and lesions stented, and lesion morphology. The relative costs of the femoral and radial procedures were examined using a decision analytic model and sensitivity analysis. The suture device was not used in 20/109 patients (18%) for anatomic reasons and failed to obtain hemostasis in 9/89 patients (10%). One radial patient had an occluded radial artery postprocedure, but this was recanalized at follow-up a month later. Primary success, procedural complications, postprocedure length of stay, and the percentage of patients discharged the same day were the same in both groups. Because of the added time to deploy Perclose, total procedure time was significantly longer in the femoral group (57 ± 22 min femoral vs. 44 ± 22 min radial, P < 0.01). Access site complications occurred only in the femoral group. More patients were ambulatory the same day of the procedure in the radial group (95% radial vs. 56% femoral, P < 0.01). The cost of the radial approach was substantially less than the femoral approach because of lower supply costs and fewer access complications. The transradial approach is a dominant strategy for coronary stenting, offering better outcomes at lower cost. (C) 2000 Wiley-Liss, Inc.
AB - The purpose of this study was to determine if closure of the femoral artery access site using a percutaneous arterial suture device (Perclose, Menlo Park, CA) in patients undergoing coronary stenting can result in the same benefits as seen with radial artery access. A total of 218 consecutive patients underwent coronary stenting (109 femoral, 109 radial) by investigators experienced with each technique. The two groups were matched in terms of sex, age, clinical presentation (50% acute), number of vessels and lesions stented, and lesion morphology. The relative costs of the femoral and radial procedures were examined using a decision analytic model and sensitivity analysis. The suture device was not used in 20/109 patients (18%) for anatomic reasons and failed to obtain hemostasis in 9/89 patients (10%). One radial patient had an occluded radial artery postprocedure, but this was recanalized at follow-up a month later. Primary success, procedural complications, postprocedure length of stay, and the percentage of patients discharged the same day were the same in both groups. Because of the added time to deploy Perclose, total procedure time was significantly longer in the femoral group (57 ± 22 min femoral vs. 44 ± 22 min radial, P < 0.01). Access site complications occurred only in the femoral group. More patients were ambulatory the same day of the procedure in the radial group (95% radial vs. 56% femoral, P < 0.01). The cost of the radial approach was substantially less than the femoral approach because of lower supply costs and fewer access complications. The transradial approach is a dominant strategy for coronary stenting, offering better outcomes at lower cost. (C) 2000 Wiley-Liss, Inc.
KW - Angioplasty
KW - Coronary artery disease
KW - Radial artery
KW - Stents
KW - Vascular complications
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U2 - 10.1002/(SICI)1522-726X(200002)49:2<150::AID-CCD7>3.0.CO;2-F
DO - 10.1002/(SICI)1522-726X(200002)49:2<150::AID-CCD7>3.0.CO;2-F
M3 - Article
C2 - 10642762
AN - SCOPUS:0033973135
SN - 1522-1946
VL - 49
SP - 150
EP - 156
JO - Catheterization and Cardiovascular Interventions
JF - Catheterization and Cardiovascular Interventions
IS - 2
ER -