Cardiology Department, 175679Sakarya University Education and Research Hospital, Sakarya, Turkey.
Cardiology Department, Vakfıkebir State Hospital, Trabzon, Turkey.
Angiology. 2020 Oct;71(9):847-852. doi: 10.1177/0003319720940128. Epub 2020 Jul 10.
Access site complications are more common with femoral access (FA) than radial access (RA). However, due to the higher rate of failure and crossover, door-to-balloon time (DBT) is prolonged by RA. Records of 3600 patients who underwent primary percutaneous coronary intervention (pPCI) between January 2016 and June 2019 were retrospectively reviewed. A total of 130 patients with crossover from RA to FA were identified and compared with the data of 501 patients who underwent pPCI with successful RA during 2018. Regression analysis was performed to determine the predictors of crossover. Crossover to the femoral approach occurred in 5.9% of our cases. Mean DBT was 17 minutes longer in the crossover group (61 ± 72 minutes vs 78 ± 79 minutes, = .026). Female sex (odds ratio [OR]: 1.8; 95% CI, 0.99-3.46, = .046) and anterior myocardial infarction (AntMI; OR: 0.52; 95% CI, 0.33-0.88, = .007) were independent predictors of crossover. In-hospital mortality rates were significantly higher in the crossover group than in the radial success group (5.4% vs 1.8%, = .020). Crossover to FA due to radial failure is associated with delayed DBT and increased rate of in-hospital mortality. Female sex and AntMI were primary predictors of crossover.
经股动脉入路（FA）的入路并发症比经桡动脉入路（RA）更为常见。然而，由于 RA 的失败率和交叉更高，球囊到达时间（DBT）延长。回顾了 2016 年 1 月至 2019 年 6 月期间接受经皮冠状动脉介入治疗（pPCI）的 3600 例患者的记录。确定了 130 例从 RA 转为 FA 的交叉患者，并与 2018 年成功接受 RA 治疗的 501 例 pPCI 患者的数据进行了比较。进行回归分析以确定交叉的预测因素。我们的病例中有 5.9%发生交叉到股动脉入路。交叉组的平均 DBT 延长了 17 分钟（61 ± 72 分钟 vs 78 ± 79 分钟， =.026）。女性（优势比 [OR]：1.8；95%置信区间，0.99-3.46， =.046）和前壁心肌梗死（AntMI；OR：0.52；95%置信区间，0.33-0.88， =.007）是交叉的独立预测因素。交叉组的院内死亡率明显高于 RA 成功组（5.4%比 1.8%， =.020）。由于桡动脉失败而转为 FA 与 DBT 延迟和院内死亡率增加有关。女性和 AntMI 是交叉的主要预测因素。
