Roeschl, Tobias and Jano, Anas M. and Fochler, Franziska and Grewe, Mona M. and Wacker, Marlis and Meier, Kirstin and Schmidt, Christian and Maier, Lars and Grewe, Peter H. (2022) Prevalence and predictors of difficult vascular anatomy in forearm artery access for coronary angiography and PCI. SCIENTIFIC REPORTS, 12 (1): 13060. ISSN 2045-2322,
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Transradial access has established as preferred access for cardiac catheterization. Difficult vascular anatomy (DVA) is a noticeable threat to procedural success. We retrospectively analyzed 1397 consecutive cardiac catheterizations to estimate prevalence and identify predictors of DVA. In the subclavian-innominate-aortic-region (SIAR), DVA was causing failure in 2.4% during right-sided vs. 0.7% in left-sided forearm-artery-access (FAA) attempts (chi(2) = 5.1, p = 0.023). Independent predictors were advanced age [odds ratio (OR) 1.44 per 10-year increase, 95% confidence interval (CI) 1.15 to 1.80, p = 0.001] and right FAA (OR 2.52, 95% CI 1.72 to 3.69, p < 0.001). In the radial-ulnar-brachial region (RUBR), DVA was causing failure in 2.5% during right-sided vs. 1.7% in left-sided FAA (chi(2) = 0.77, p = 0.38). Independent predictors were age (OR 1.28 per 10-year increase, 95% CI 1.01 to 1.61, p = 0.04), lower height (OR 1.56 per 10-cm decrease, 95% CI 1.13 to 2.15, p = 0.008) and left FAA (OR 2.15, 95% CI 1.45 to 3.18, p < 0.001). Bilateral DVA was causing procedural failure in 0.9% of patients. The prevalence of bilateral DVA was rare. Predictors in SIAR were right FAA and advanced age and in RUBR, left FAA, advanced age and lower height. Gender, arterial hypertension, body mass, STEMI and smoking were not associated with DVA.
| Item Type: | Article |
|---|---|
| Uncontrolled Keywords: | RADIAL ARTERY; TRANSRADIAL APPROACH; TORTUOSITY; CATHETERIZATION; COMPLICATIONS; FAILURE; IMPACT; |
| Subjects: | 600 Technology > 610 Medical sciences Medicine |
| Divisions: | Medicine > Lehrstuhl für Innere Medizin II |
| Depositing User: | Dr. Gernot Deinzer |
| Date Deposited: | 27 Feb 2024 06:26 |
| Last Modified: | 27 Feb 2024 06:26 |
| URI: | https://pred.uni-regensburg.de/id/eprint/57824 |
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