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Article

Comparison of Access Site-Related Complications and Quality of Life in Patients after Invasive Cardiology Procedures According to the Use of Radial, Femoral, or Brachial Approach

1
Students’ Scientific Group at the Second Department of Cardiology, Jagiellonian University Medical College, 30-688 Cracow, Poland
2
Department of Cardiology and Cardiovascular Interventions, University Hospital, 2 Jakubowskiego Street, 30-688 Cracow, Poland
3
Center for Intensive Care and Perioperative Medicine, Faculty of Medicine, Jagiellonian University Medical College, 30-901 Cracow, Poland
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Second Department of Cardiology, Institute of Cardiology, Faculty of Medicine, Jagiellonian University Medical College, 30-688 Cracow, Poland
*
Author to whom correspondence should be addressed.
Co-first author, these authors contributed equally to this work.
Academic Editors: Paul B. Tchounwou and Salah A. Mohamed
Int. J. Environ. Res. Public Health 2021, 18(11), 6151; https://doi.org/10.3390/ijerph18116151
Received: 11 May 2021 / Revised: 26 May 2021 / Accepted: 5 June 2021 / Published: 7 June 2021
The radial approach (RA) is the most common in invasive cardiology, but depending on the clinical situation, the femoral approach (FA) and brachial approach (BA) are also used. The BA is associated with the highest odds of complications so it is used mainly if a first-choice approach fails. The aim of the study was to assess clinical outcomes after invasive cardiology procedures stratified by the use of the RA, FA, and BA, with a focus on access site-related complications, quality of life (QoL), and patients’ perspective. A total of 250 procedures (RA: 98; FA: 99; BA: 53) performed between 2013 and 2020 were retrospectively analyzed. Puncture site-related complications, vascular events, patient preferences, and QoL were assessed by the analysis of medical records and telephone follow-up using a proprietary questionnaire and the modified EQ-5D-3L questionnaire. Patients from the RA group received the smallest volume of contrast during a percutaneous coronary interventions (PCI) procedure (RA vs. FA vs. BA: 180 (150–240) mL vs. 200 (180–270) mL vs. 190 (100–200) mL, p = 0.045). The access site was changed most frequently in the procedures initiated from the RA (p < 0.04). Overall puncture site-related complications, especially local hematomas, occurred most commonly in the BA group (7.1, 14.1, and 24.5% for RA, FA, and BA, respectively, p = 0.01). During the index procedure, the access site was changed most frequently in procedures initiated from the RA (19.7, 8.5 and 0%, p = 0.04). The RA was indicated as an approach preferred by the patient for a hypothetical next procedure (87.9, 55.4, and 70.0% for subjects preferring the same approach out of patients who underwent a procedure by the RA, FA, and BA, respectively, p < 0.001). For the RA and FA, the prevalence of moderate or extreme access site-related problems in self-care decreased significantly (RA: p < 0.01, FA: p < 0.05) within 1 month after the index procedure (RA: 18.1, 4.2, and 1.4%; FA: 20.7, 11.1, and 9.6% periprocedurally, after 1 and 6 months, respectively). In contrast, for the BA these percentages were higher and a significant improvement (p < 0.05) was delayed until 6 months (54.6, 36.4, and 18.2% periprocedurally, after 1 and 6 months, respectively). In conclusion, compared to the BA and FA, the RA appears to be not only the safest, mainly due to the lowest risk of puncture site-related complications after coronary procedures but also represents a preferable approach from the patient’s perspective. Although overall post-procedural QoL outcomes did not differ significantly according to the access site, nevertheless, the BA was associated with more frequent self-care problems whose improvement was delayed until more than one month after the index procedure. View Full-Text
Keywords: periprocedural complications; quality of life; cardiovascular interventions periprocedural complications; quality of life; cardiovascular interventions
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MDPI and ACS Style

Roczniak, J.; Koziołek, W.; Piechocki, M.; Tokarek, T.; Surdacki, A.; Bartuś, S.; Chyrchel, M. Comparison of Access Site-Related Complications and Quality of Life in Patients after Invasive Cardiology Procedures According to the Use of Radial, Femoral, or Brachial Approach. Int. J. Environ. Res. Public Health 2021, 18, 6151. https://doi.org/10.3390/ijerph18116151

AMA Style

Roczniak J, Koziołek W, Piechocki M, Tokarek T, Surdacki A, Bartuś S, Chyrchel M. Comparison of Access Site-Related Complications and Quality of Life in Patients after Invasive Cardiology Procedures According to the Use of Radial, Femoral, or Brachial Approach. International Journal of Environmental Research and Public Health. 2021; 18(11):6151. https://doi.org/10.3390/ijerph18116151

Chicago/Turabian Style

Roczniak, Jan, Wojciech Koziołek, Marcin Piechocki, Tomasz Tokarek, Andrzej Surdacki, Stanisław Bartuś, and Michał Chyrchel. 2021. "Comparison of Access Site-Related Complications and Quality of Life in Patients after Invasive Cardiology Procedures According to the Use of Radial, Femoral, or Brachial Approach" International Journal of Environmental Research and Public Health 18, no. 11: 6151. https://doi.org/10.3390/ijerph18116151

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