Source:http://linkedlifedata.com/resource/pubmed/id/10627362
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| Predicate | Object |
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| rdf:type | |
| lifeskim:mentions | |
| pubmed:issue |
1
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| pubmed:dateCreated |
2000-2-3
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| pubmed:abstractText |
Peripheral vascular disease is considered a relative contraindication to the femoral approach for coronary angiography, but no data exist comparing the femoral and brachial/radial routes under these circumstances. We examined the influence of vascular approach on outcome. Two hundred and ninety-seven patients, mean age 67.1 +/- 8.4 years, with clinical or radiographic evidence of aortofemoral peripheral arterial disease underwent diagnostic coronary angiography during a 3-year period at this cardiothoracic center. The approach was successful in 121 of 154 femoral cases (79%) compared with 130 of 143 brachial/radial cases (91%; P < 0.01). Of the 33 failed femoral cases, 15 were then approached from the other femoral artery, with success in 6 (40%), while 18 were approached from the arm, with success in all (100%; P < 0.01). Brachial/radial cases took significantly longer than femoral cases (51 +/- 19 vs. 42 +/- 22 mins; P < 0.01). In cases where the femoral pulse was considered normal, the femoral approach nonetheless failed in 19 of 95 (20%). Major vascular complications (e.g., pulseless limb, arterial dissection, hemorrhage, or false aneurysm) occurred in nine femoral cases vs. zero brachial/radial cases (P < 0.01). Patients with peripheral vascular disease who undergo coronary angiography from the femoral artery have a 1-in-5 risk of procedural failure, necessitating use of an alternative vascular approach, and a 1-in-20 risk of a major vascular complication. Normality of femoral arterial pulsation is not a good predictor of femoral success. Brachial/radial approaches take longer, but succeed more frequently and have a negligible major vascular complication rate. We believe that patients with peripheral vascular disease should undergo coronary angiography via brachial or radial approach. Cathet. Cardiovasc. Intervent. 49:32-37, 2000.
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| pubmed:commentsCorrections | |
| pubmed:language |
eng
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| pubmed:journal | |
| pubmed:citationSubset |
IM
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| pubmed:status |
MEDLINE
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| pubmed:month |
Jan
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| pubmed:issn |
1522-1946
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| pubmed:author | |
| pubmed:copyrightInfo |
Copyright 2000 Wiley-Liss, Inc.
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| pubmed:issnType |
Print
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| pubmed:volume |
49
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| pubmed:owner |
NLM
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| pubmed:authorsComplete |
Y
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| pubmed:pagination |
32-7
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| pubmed:dateRevised |
2004-11-17
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| pubmed:meshHeading |
pubmed-meshheading:10627362-Aged,
pubmed-meshheading:10627362-Brachial Artery,
pubmed-meshheading:10627362-Catheterization, Peripheral,
pubmed-meshheading:10627362-Coronary Angiography,
pubmed-meshheading:10627362-Coronary Disease,
pubmed-meshheading:10627362-Female,
pubmed-meshheading:10627362-Femoral Artery,
pubmed-meshheading:10627362-Humans,
pubmed-meshheading:10627362-Male,
pubmed-meshheading:10627362-Peripheral Vascular Diseases,
pubmed-meshheading:10627362-Radial Artery,
pubmed-meshheading:10627362-Retrospective Studies
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| pubmed:year |
2000
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| pubmed:articleTitle |
Coronary angiography in the presence of peripheral vascular disease: femoral or brachial/radial approach?
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| pubmed:affiliation |
Department of Cardiology, Papworth Hospital, Cambridgeshire, United Kingdom. david.hildick-smith@papworth-tr.anglox.nhs.uk
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| pubmed:publicationType |
Journal Article
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