Transfemoral Approach for Coronary Angiography and Intervention: A Collaboration of International Cardiovascular Societies.

Damluji, Abdulla A; Nelson, Daniel W; Valgimigli, Marco; Windecker, Stephan; Byrne, Robert A; Cohen, Fernando; Patel, Tejas; Brilakis, Emmanouil S; Banerjee, Subhash; Mayol, Jorge; Cantor, Warren J; Alfonso, Carlos E; Rao, Sunil V; Moscucci, Mauro; Cohen, Mauricio G (2017). Transfemoral Approach for Coronary Angiography and Intervention: A Collaboration of International Cardiovascular Societies. JACC. Cardiovascular Interventions, 10(22), pp. 2269-2279. Elsevier 10.1016/j.jcin.2017.08.035

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OBJECTIVES The aim of this study was to examine the current practice and use of transfemoral approach (TFA) for coronary angiography and intervention. BACKGROUND Wide variability exists in TFA techniques for coronary procedures. METHODS The authors developed a survey instrument that was distributed via e-mail lists from professional societies to interventional cardiologists from 88 countries between March and December 2016. RESULTS Of 987 operators, 18% were femoralists, 38% radialists, 42% both, and 2% neither. Access using femoral pulse palpation alone was preferred by 60% of operators, fluoroscopy guidance by 11%, and a combination of palpation, fluoroscopy, or ultrasound by 27%. Only 11% used micropuncture in >90% of their cases. Performing femoral angiography immediately after access was preferred by 23% and at the end of the procedure by 47%, and not done at all by 31% of operators. Hemostasis by manual compression was preferred by 50%, collagen plug vascular closure device by 31%, and suture-based vascular closure device by 11% of operators. Judkins left and right catheters were preferred for diagnostic angiography of the left (99%) and right (94%) coronary arteries. Extra backup curves (XB or EBU) were most commonly preferred for percutaneous coronary intervention of the left anterior descending (80%) and left circumflex (80%), whereas the Judkins right catheter was preferred for percutaneous coronary intervention of the right coronary artery (86%). CONCLUSIONS There is significant variability in preferences for femoral access technique. Even though recommended best practices advocate for fluoroscopic and ultrasound guidance, most operators use palpation alone. Femoral angiography is also not consistently used despite guideline recommendations. The lack of adoption of imaging guidance for vascular access deserves further investigation.

Item Type:

Journal Article (Original Article)

Division/Institute:

04 Faculty of Medicine > Department of Cardiovascular Disorders (DHGE) > Clinic of Cardiology

UniBE Contributor:

Valgimigli, Marco and Windecker, Stephan

Subjects:

600 Technology > 610 Medicine & health

ISSN:

1876-7605

Publisher:

Elsevier

Language:

English

Submitter:

Nadia Biscozzo

Date Deposited:

08 Feb 2018 11:26

Last Modified:

08 Feb 2018 11:26

Publisher DOI:

10.1016/j.jcin.2017.08.035

PubMed ID:

29169496

Uncontrolled Keywords:

PCI stent survey transfemoral

BORIS DOI:

10.7892/boris.111058

URI:

https://boris.unibe.ch/id/eprint/111058

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