No Difference in 30-Day Outcome and Quality of Life in Transradial Versus Transfemoral Access - Results From the German Austrian ABSORB Registry (GABI-R).
Bastian Wein, Myron Zaczkiewicz, Matthias Graf, Oliver Zimmermann, Tommaso Gori, Holger M Nef, Johannes Kastner, Julinda Mehilli, Gert Richardt, Jochen Wöhrle, Stephan Achenbach, Thomas Riemer, Christian Hamm, Jan Torzewski
Cardiovascular revascularization medicine : including molecular interventions 2022 JulRadial (RA) instead of femoral access (FA) for coronary interventions has become a European Society of Cardiology Class-IA guideline recommendation. But when the decision on the access site is left to the discretion of the operator, differences in adverse event rates mitigate. We compared the 30-day outcome for RA and FA in all patients recruited for the observational German Austrian ABSORB Registry (GABI-R) in regard to all-cause mortality, stroke, myocardial infarction (MI), TIMI major bleedings (TMB) and quality of life (QoL). All patients were treated with a bioresorbable vascular scaffold. Access site was left to the discretion of the operator. In total, 3137 patients included by 92 centers received percutaneous coronary interventions (PCI) for acute MI in 51.5% and non-acute settings in 48.5%. RA was performed in 47.8% and had a higher median radiation exposure (3896 vs. 3082 cGycm2, p < 0.001). There was no difference in the amount of contrast used. There was also no difference in all-cause mortality (0.53% vs. 0.49%, p = 0.86), the combination of death, MI and stroke (1.87% vs. 1.83%, p = 0.94), but a trend towards more TMB (0.47% vs. 1.04%, p = 0.07) with FA. These outcomes were consistent across the subgroups of patients with ST-elevation MI, non-ST-elevation-ACS and stable coronary artery disease. Finally, QoL did not differ between RA and FA. In this contemporary GABI-R cohort, in which access site was left to the discretion of the operator, both access routes were safe and equal concerning QoL (ClinicalTrials.gov; NCT02066623). Copyright © 2021 Elsevier Inc. All rights reserved.
Citation
Bastian Wein, Myron Zaczkiewicz, Matthias Graf, Oliver Zimmermann, Tommaso Gori, Holger M Nef, Johannes Kastner, Julinda Mehilli, Gert Richardt, Jochen Wöhrle, Stephan Achenbach, Thomas Riemer, Christian Hamm, Jan Torzewski. No Difference in 30-Day Outcome and Quality of Life in Transradial Versus Transfemoral Access - Results From the German Austrian ABSORB Registry (GABI-R). Cardiovascular revascularization medicine : including molecular interventions. 2022 Jul;40:144-149
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PMID: 34844868
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