Femoral Access PCI in a Default Radial Center Identifies High-Risk XXXX With Poor Outcomes.

@entity1 @entity177 @entity204 @entity548
BACKGROUND: Increasingly the trans-radial route (TRR) is preferred over the trans-femoral route (TFR) for PCI. However, even in high volume default TRR centers a cohort of @entity1 undergo TFR PCI. We examined the demographics, procedural characteristics, and outcomes of @entity1 undergoing PCI via the TF. METHODS: The @entity1 demographics, procedural data, and outcomes of 5,379 consecutive @entity1 undergoing PCI at a default radial center between 2009 and 2012 were examined. @entity548 ( @entity548 ) was classified by ACUITY and BARC definitions. RESULTS: A total of 559 (10.4%) @entity1 underwent PCI via the TFR and 4,820 @entity1 via the TRR (89.6%). Baseline variables associated with TFR were shock, previous CABG, chronic total occlusion intervention, rotablation/laser use, female sex, and @entity177 . Sixty-five @entity1 of the TFR cohort (11.6%) experienced @entity548 with 27 (41.5%) being access site related. @entity548 was significantly more frequent than in the radial cohort. The variables independently associated with @entity548 in the TFR cohort were @entity177 , acute presentation, shock, and age. In the TFR, @entity1 with @entity548 mortality was high at 30 days (17.2% vs 2.6% for no @entity548 , P   <   0.0001) and at 1 year (37.6% vs 5.0%, P   <   0.0001). Shock and @entity548 were highly predictive of 30 day and 12 month mortality. CONCLUSION: In a default radial PCI center 10% of @entity1 undergo PCI via the femoral artery. These @entity1 have high baseline @entity548 risk and undergo complex interventions. As a result the incidence of major @entity548 , transfusion and @entity204 are high. Alternative strategies are required to optimize outcomes in this select group.
