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Predictors of radial to femoral artery crossover during primary percutaneous coronary intervention in ST-elevation myocardial infarction: A systematic review and meta-analysis

Published:December 07, 2022DOI:https://doi.org/10.1016/j.aucc.2022.10.018

      Abstract

      Background

      In contrast to traditional femoral artery access, radial artery access for primary percutaneous coronary intervention (PPCI) in ST-elevation myocardial infarction (STEMI) is associated with reduced mortality and bleeding but has higher crossover rates. Therefore, factors associated with crossover warrant exploration as crossover due to technical challenges associated with the radial route may be mitigated.

      Objective

      The objective of this study was to identify predictors of radial access failure or crossover to femoral access in PPCI.

      Methods

      A systematic review and meta-analysis was undertaken according to the Joanna Briggs Institute Systematic Reviews Checklist with searches conducted in Medline, EMBASE, CINAHL, and SCOPUS databases. Inclusion criteria for this study included patients with STEMI; PPCI; and primary research identifying predictors of radial access failures and/or crossovers, published in English, and after 2010. This study was registered with PROSPERO (CRD42020167122). Statistical analysis was performed using IBM SPSS Statistics for Windows version 26.0 (IBM Corp, Armonk, NY) and RevMan version 5.4 (Cochrane Collaboration, London, United Kingdom) with meta-analysis conducted by using the DerSimonian and Laird random-effects method. The National Heart, Lung, and Blood Institute Quality Assessment Tool for Observational Cohort and Cross-Sectional Studies was utilised for quality and risk of bias assessment, with EndNote software used for citations.

      Results

      Eight observational studies met inclusion criteria, comprising 12,621 patients. Risk of bias of these studies was assessed using the National Heart, Lung, and Blood Institute Quality Assessment Tool for Observational Cohort and Cross-Sectional Studies. The mean age was 61.2 ± 12.0 years, and 75.3% were male. Crossover from transradial to transfemoral artery occurred in 529 (4.2%) patients. Reasons for radial access failure included failed puncture (35.3%), peripheral occlusion or tortuosity (24.5%), and radial artery spasm (20.1%). Predictors of crossover included older age (odds ratio [OR], 1.95; 95% confidence interval [CI], 1.44–2.65; p < 0.001), female sex (OR, 2.10; 95% Cl, 1.58–2.80; p < 0.001), weight ≤65 kg (OR, 2.95; 95% CI, 1.95–4.46; p < 0.001), and previous percutaneous coronary intervention (OR, 2.80; 95% Cl, 1.74–4.52; p < 0.001).

      Conclusion

      Older age, female sex, weight ≤65 kg, and previous percutaneous coronary intervention were predictors of crossover or failure from the radial to femoral artery. As these predictors are known to be associated with high bleeding and mortality, they should not preclude attempting a radial-first approach in all patients with STEMI. However, as these results were unadjusted, this study warrants further research to thoroughly investigate predictors of radial artery crossover.

      Keywords

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      References

        • Neumann F.J.
        • Sousa-Uva M.
        • Ahlsson A.
        • Alfonso F.
        • Banning A.P.
        • Benedetto U.
        • et al.
        2018 ESC/EACTS Guidelines on myocardial revascularization.
        Eur Heart J. 2019; 40: 87-165https://doi.org/10.1093/eurheartj/ehy394
        • Chew D.P.
        • Scott I.A.
        • Cullen L.
        • French J.K.
        • Briffa T.G.
        • Tideman P.A.
        • et al.
        National Heart Foundation of Australia & Cardiac Society of Australia and New Zealand: Australian clinical guidelines for the management of acute coronary syndromes 2016.
        Heart Lung Circ. Sep 2016; 25: 895-951https://doi.org/10.1016/j.hlc.2016.06.789
        • Zafirovska B.
        • Antov S.
        • Kostov J.
        • Spiroski I.
        • Vasilev. I.
        • Jovkovski A.
        • et al.
        Benefit of routine preprocedural radial artery angiography in STEMI patients.
        Catheter Cardiovasc Interv: Off J Soc Cardiac Angiography Interv. 2019; 93 (Comment in: Catheter Cardiovasc Interv. 2019 Feb 15;93(3):E195-E196; PMID: 30770666): 25-31https://doi.org/10.1002/ccd.27711
        • Romagnoli E.
        • Biondi-Zoccai G.
        • Sciahbasi A.
        • Politi L.
        • Rigattieri S.
        • Pendenza G.
        • et al.
        Radial versus femoral randomized investigation in ST-segment elevation acute coronary syndrome: the RIFLE-STEACS (Radial versus Femoral Randomized Investigation in ST-Elevation Acute Coronary Syndrome) study.
        J Am Coll Cardiol. Dec 18 2012; 60: 2481-2489https://doi.org/10.1016/j.jacc.2012.06.017
        • Bernat I.
        • Horak D.
        • Stasek J.
        • Mates M.
        • Pesek J.
        • Ostadal P.
        • et al.
        ST-segment elevation myocardial infarction treated by radial or femoral approach in a multicenter randomized clinical trial: the STEMI-RADIAL trial.
        J Am Coll Cardiol. Mar 18 2014; 63: 964-972https://doi.org/10.1016/j.jacc.2013.08.1651
        • Jolly S.S.
        • Yusuf S.
        • Cairns J.
        • Niemela K.
        • Xavier D.
        • Widimsky P.
        • et al.
        Radial versus femoral access for coronary angiography and intervention in patients with acute coronary syndromes (RIVAL): a randomised, parallel group, multicentre trial.
        Lancet. Apr 23 2011; 377: 1409-1420https://doi.org/10.1016/S0140-6736(11)60404-2
        • Romagnoli E.
        • Biondi-Zoccai G.
        • Sciahbasi A.
        • Politi L.
        • Rigattieri S.
        • Pendenza G.
        • et al.
        Radial versus femoral randomized investigation in ST-segment elevation acute coronary syndrome.
        J Am Coll Cardiol. 2012; 60: 2481-2489https://doi.org/10.1016/j.jacc.2012.06.017
        • Valgimigli M.
        • Gagnor A.
        • Calabró P.
        • Frigoli E.
        • Leonardi S.
        • Zaro T.
        • et al.
        Radial versus femoral access in patients with acute coronary syndromes undergoing invasive management: a randomised multicentre trial.
        Lancet (London, England). Jun 20 2015; 385: 2465-2476https://doi.org/10.1016/s0140-6736(15)60292-6
        • Dowling C.
        • Rao S.
        • Kerr N.
        • Muller D.
        Radial versus femoral access for cardiac catheterisation.
        Lancet (London, England). Dec 12 2015; 386: 2392https://doi.org/10.1016/s0140-6736(15)01195-2
        • Le May M.
        • Wells G.
        • So D.
        • Chong A.Y.
        • Dick A.
        • Froeschl M.
        • et al.
        Safety and efficacy of femoral access vs radial access in ST-segment elevation myocardial infarction: the SAFARI-STEMI randomized clinical trial.
        JAMA Cardiol. Feb 1 2020; 5: 126-134https://doi.org/10.1001/jamacardio.2019.4852
        • Ibanez B.
        • James S.
        • Agewall S.
        • Antunes M.J.
        • Bucciarelli-Ducci C.
        • Bueno H.
        • et al.
        2017 ESC Guidelines for the management of acute myocardial infarction in patients presenting with ST-segment elevation: the Task force for the management of acute myocardial infarction in patients presenting with ST-segment elevation of the European Society of Cardiology (ESC).
        Eur Heart J. Jan 7 2018; 39: 119-177https://doi.org/10.1093/eurheartj/ehx393
        • O’Gara Patrick T.
        • Kushner Frederick G.
        • Ascheim Deborah D.
        • Casey Donald C.
        • Chung Mina K.
        • De Lemos James A.
        • et al.
        2013 ACCF/AHA guideline for the management of ST-elevation myocardial infarction: executive summary.
        Circulation. 2013; 127: 529-555https://doi.org/10.1161/CIR.0b013e3182742c84
        • Mason P.J.
        • Shah B.
        • Tamis-Holland J.E.
        • Bittl J.A
        • Cohen M.G.
        • Safirstein J.
        • et al.
        An update on radial artery access and best practices for transradial coronary angiography and intervention in acute coronary syndrome: a scientific statement from the American Heart association.
        Circ Cardiovasc Interv. Sep 2018; 11e000035https://doi.org/10.1161/hcv.0000000000000035
        • Dang D.
        • Kuhn L.
        • Fooladi E.
        • Ky V.
        • Cheung K.
        • Rashid H.
        • et al.
        Predictors of radial to femoral artery access crossover during primary percutaneous coronary intervention for ST-elevation myocardial infarction.
        Heart Lung Circ. 2022; https://doi.org/10.1016/j.hlc.2022.01.016
        • Valgimigli M.
        • Frigoli E.
        • Leonardi S.
        • Vranckx P.
        • Rothenbühler M.
        • Tebaldi M.
        • et al.
        Radial versus femoral access and bivalirudin versus unfractionated heparin in invasively managed patients with acute coronary syndrome (MATRIX): final 1-year results of a multicentre, randomised controlled trial.
        Lancet. 2018/09/08/2018; 392: 835-848https://doi.org/10.1016/S0140-6736(18)31714-8
        • Joanna Briggs I.
        • University of A.
        JBI database of systematic reviews and implementation reports.
        in: Joanna Briggs Institute database of systematic reviews and implementation reports. 2013
        • Page M.J.
        • McKenzie J.E.
        • Bossuyt P.M.
        • Boutron I.
        • Hoffmann T.C.
        • Mulrow C.D.
        • et al.
        The PRISMA 2020 statement: an updated guideline for reporting systematic reviews.
        BMJ. 2021; 372: n71https://doi.org/10.1136/bmj.n71
        • Feldman Dmitriy N.
        • Swaminathan Rajesh V.
        • Kaltenbach Lisa A.
        • Baklanov Dmitri V.
        • Kim Luke K.
        • Wong S.C.
        • et al.
        Adoption of radial access and comparison of outcomes to femoral access in percutaneous coronary intervention.
        Circulation. 2013; 127: 2295-2306https://doi.org/10.1161/CIRCULATIONAHA.112.000536
        • Kellermeyer L.
        • Harnke B.
        • Knight S.
        Covidence and rayyan.
        J Med Libr Assoc. 2018; 106: 580-583https://doi.org/10.5195/jmla.2018.513
        • National Heart L, and Blood Institute
        Quality Assessment tool for observational cohort and crosssectional studies.
        2021
        • DerSimonian R.
        • Laird N.
        Meta-analysis in clinical trials.
        Control Clin Trials. Sep 1986; 7: 177-188https://doi.org/10.1016/0197-2456(86)90046-2
        • Abdelaal E.
        • MacHaalany J.
        • Plourde G.
        • Barria Perez A.
        • Bouchard M.P.
        • Roy M.
        • et al.
        Prediction and impact of failure of transradial approach for primary percutaneous coronary intervention.
        Heart. Jun 15 2016; 102: 919-925https://doi.org/10.1136/heartjnl-2015-308371
        • Azzalini L.
        • Khan R.
        • Al-Hawwas M.
        • Hatem R.
        • Fortier A.
        • L’Allier P.L.
        • et al.
        Effect of radial-to-femoral access crossover on adverse outcomes in primary percutaneous coronary intervention.
        Am J Cardiol. Oct 15 2014; 114: 1165-1173https://doi.org/10.1016/j.amjcard.2014.07.033
        • Gellen B.
        • Lesault P.F.
        • Canouï-Poitrine F.
        • Champagne S.
        • Mouillet G.
        • Pongas D.
        • et al.
        Feasibility limits of transradial primary percutaneous coronary intervention in acute myocardial infarction in the real life (TRAP-AMI).
        Int J Cardiol. Sep 30 2013; 168: 1056-1061https://doi.org/10.1016/j.ijcard.2012.10.024
        • Hernández-Pérez F.J.
        • Blasco-Lobo A.
        • Goicolea L.
        • Muñiz-Lozano A.
        • Fernandez-Díaz J.A.
        • Domínguez J.R.
        • et al.
        Use of the radial approach in primary angioplasty: results in 1029 consecutive patients and analyses in unfavorable subgroups.
        Rev Esp Cardiol (English ed). Jan 2014; 67: 45-51https://doi.org/10.1016/j.rec.2013.06.015
        • Rubartelli P.
        • Crimi G.
        • Bartolini D.
        • Bellotti S.
        • Iannone A.
        • Fontana V.
        Switching from femoral to routine radial access site for ST-elevation myocardial infarction: a single center experience.
        J Intervent Cardiol. Dec 2014; 27: 591-599https://doi.org/10.1111/joic.12157
        • Vink M.A.
        • Amoroso G.
        • Dirksen M.T.
        • van der Schaaf R.J.
        • Patterson M.S.
        • Tijssen T.G.
        • et al.
        Routine use of the transradial approach in primary percutaneous coronary intervention: procedural aspects and outcomes in 2209 patients treated in a single high-volume centre.
        Heart. 2011; 97: 1938-1942https://doi.org/10.1136/heartjnl-2011-300524
        • Zafirovska B.
        • Antov S.
        • Kostov J.
        • Spiroski I.
        • Vasilev I.
        • Jovkovski A.
        • et al.
        Benefit of routine preprocedural radial artery angiography in STEMI patients.
        Catheter Cardiovasc Interv: Off J Soc Cardiac Angiography Interv. Jan 1 2019; 93: 25-31https://doi.org/10.1002/ccd.27711
        • Şahinkuş S.
        • Aksoy M.N.M.
        • Aydin E.
        Predictors and clinical outcomes of crossover from radial to femoral access during primary percutaneous coronary intervention.
        Angiology. 2020/10/01 2020; 71: 847-852https://doi.org/10.1177/0003319720940128
        • Neumann F.-J.
        • Sousa-Uva M.
        • Ahlsson A.
        • Alfonso F.
        • Banning A.P.
        • Benedetto U.
        • et al.
        ESC/EACTS Guidelines on myocardial revascularization.
        Eur Heart J. 2018; 40 (2018): 87-165https://doi.org/10.1093/eurheartj/ehy394
        • Zafirovska B.
        • Antov S.
        • Kostov J.
        • Spiroski I.
        • Vasilev I.
        • Jovkovski A.
        • et al.
        Benefit of routine preprocedural radial artery angiography in STEMI patients.
        Cathet Cardiovasc Interv. 2019; 93: 25-31https://doi.org/10.1002/ccd.27711
        • Dery J.P.
        • Dery U.
        • Bouchard M.P.
        • Roy M.
        • Rodes-Cabau J.
        • Rinfret S.
        • et al.
        Adequate screening can reduce radial access failure rates in ST-elevation myocardial infarction patients undergoing primary percutaneous coronary intervention.
        J Invasive Cardiol. 2012; 24 (1st Advanced International Masterclass, AIM RADIAL 2012. Quebec City, QC Canada)
        • Shanmugam V.B.
        • Harper R.
        • Meredith I.
        • Malaiapan Y.
        • Psaltis P.J.
        An overview of PCI in the very elderly.
        J Geriatr Cardiol. 2015; 12: 174-184https://doi.org/10.11909/j.issn.1671-5411.2015.02.012
        • May A.
        Antiplatelet therapy in elderly patients.
        in: Rittger H. Interventional Cardiology in the elderly. Springer International Publishing, 2015: 135-143
        • Won H.
        • Lee W.S.
        • Kim S.-W.
        • Cho B.R.
        • Youn Y.J.
        • Lim Y.H.
        • et al.
        Safety and efficacy of transradial coronary angiography and intervention in patients older than 80 years: from the Korean Transradial Intervention Prospective Registry.
        J Geriatr Cardiol. 2017; 14: 81-86https://doi.org/10.11909/j.issn.1671-5411.2017.02.001
        • Balwanz C.R.
        • Javed U.
        • Singh G.D.
        • Armstrong E.J.
        • Southard J.A.
        • Wong G.B.
        • et al.
        Transradial and transfemoral coronary angiography and interventions: 1-Year outcomes after initiating the transradial approach in a cardiology training program.
        Am Heart J. 2013; 165: 310-316https://doi.org/10.1016/j.ahj.2012.10.014
        • Stehli J.
        • Duffy S.J.
        • Koh Y.
        • Martin C.
        • Brennan A.
        • Dinh D.T.
        • et al.
        Sex differences in radial access for percutaneous coronary intervention in acute coronary syndrome are independent of body size.
        Heart Lung Circ. 2020; https://doi.org/10.1016/j.hlc.2020.06.023
        • Pandie S.
        • Mehta S.R.
        • Cantor W.J.
        • Cheema A.N.
        • Gao P.
        • Madan M.
        • et al.
        Radial versus femoral access for coronary angiography/intervention in women with acute coronary syndromes: insights from the RIVAL trial (radial vs femoral access for coronary intervention).
        JACC Cardiovasc Interv. 2015; 8: 505-512https://doi.org/10.1016/j.jcin.2014.11.017
        • Zheng X.
        • Curtis J.P.
        • Hu S.
        • Wang Y.
        • Yang Y.
        • Masoudi F.A.
        • et al.
        Coronary catheterization and percutaneous coronary intervention in China: 10-year results from the China PEACE-retrospective CathPCI study.
        JAMA Intern Med. 2016; 176: 512-521https://doi.org/10.1001/jamainternmed.2016.0166
        • Masoudi F.A.
        • Ponirakis A.
        • de Lemos J.A.
        • Jollis J.G.
        • Kremers M.
        • Messenger J.C.
        • et al.
        Executive summary: trends in U.S. cardiovascular care: 2016 report from 4 ACC national cardiovascular data registries.
        J Am Coll Cardiol. 2017/03/21/2017; 69: 1424-1426https://doi.org/10.1016/j.jacc.2016.12.004
        • Hulme W.
        • Sperrin M.
        • Kontopantelis E.
        • Ratib K.
        • Ludman P.
        • Sirker A.
        • et al.
        Increased radial access is not associated with worse femoral outcomes for percutaneous coronary intervention in the United Kingdom.
        Circulation: Cardiovasc Interv. 2017; 10e004279
        • Gu W.J.
        • Wu X.D.
        • Wang F.
        • Ma Z.L.
        • Gu X.P.
        Ultrasound guidance facilitates radial artery catheterization: a meta-analysis with trial sequential analysis of randomized controlled trials.
        Chest. Jan 2016; 149: 166-179https://doi.org/10.1378/chest.15-1784
        • Abdelbary A.
        • Khaled M.
        • Sami W.
        • Said A.
        • Yosri M.
        • Abuelwafa M.
        • et al.
        Initial Egyptian ECMO experience.
        Egyptian J Crit Care Medicine. 2016; 4: 25-32https://doi.org/10.1016/j.ejccm.2016.01.005
        • Kiemeneij F.
        Left distal transradial access in the anatomical snuffbox for coronary angiography (ldTRA) and interventions (ldTRI).
        EuroIntervention: journal of EuroPCR in collaboration with the Working Group on Interventional Cardiology of the European Society of Cardiology. Sep 20 2017; 13: 851-857https://doi.org/10.4244/eij-d-17-00079
        • Hahalis G.N.
        • Leopoulou M.
        • Tsigkas G.
        • Xanthopoulou I.
        • Patsilinakos S.
        • Patsourakos N.G.
        • et al.
        Multicenter randomized evaluation of high versus standard heparin dose on incident radial arterial occlusion after transradial coronary angiography: the spirit of artemis study.
        JACC Cardiovasc Interv. Nov 26 2018; 11: 2241-2250https://doi.org/10.1016/j.jcin.2018.08.009
        • Patel T.
        • Shah S.
        • Pancholy S.
        • Rao S.
        • Bertrand O.F.
        • Kwan T.
        Balloon-assisted tracking: a must-know technique to overcome difficult anatomy during transradial approach.
        Catheter Cardiovasc Interv. Feb 2014; 83: 211-220https://doi.org/10.1002/ccd.24959
        • Kwok C.S.
        • Rashid M.
        • Fraser D.
        • Nolan J.
        • Mamas M.
        Intra-arterial vasodilators to prevent radial artery spasm: a systematic review and pooled analysis of clinical studies.
        Cardiovasc Revascularization Med : Mol Interv. Dec 2015; 16: 484-490https://doi.org/10.1016/j.carrev.2015.08.008
        • Rathore S.
        • Stables R.H.
        • Pauriah M.
        • Hakeem A.
        • Mills J.D.
        • Palmer N.D.
        • et al.
        Impact of length and hydrophilic coating of the introducer sheath on radial artery spasm during transradial coronary intervention: a randomized study.
        JACC Cardiovasc Interv. May 2010; 3: 475-483https://doi.org/10.1016/j.jcin.2010.03.009
        • Horie K.
        • Tada N.
        • Isawa T.
        • Matsumoto T.
        • Taguri M.
        • Kato S.
        • et al.
        A randomised comparison of incidence of radial artery occlusion and symptomatic radial artery spasm associated with elective transradial coronary intervention using 6.5 Fr SheathLess Eaucath Guiding Catheter vs. 6.0 Fr Glidesheath Slender.
        EuroIntervention: journal of EuroPCR in collaboration with the Working Group on Interventional Cardiology of the European Society of Cardiology. Apr 20 2018; 13: 2018-2025https://doi.org/10.4244/eij-d-17-00239
        • Garcia-Blas S.
        • Nunez J.
        • Mainar L.
        • Minana G.
        • Bonanad C.
        • Racugno P.
        • et al.
        Usefulness and safety of a guide catheter extension system for the percutaneous treatment of complex coronary lesions by a transradial approach.
        Med Princ Pract: Int J Kuwait Univ Health Sci Centre. 2015; 24: 171-177https://doi.org/10.1159/000369620
        • Kiemeneij F.
        • Yoshimachi F.
        • Matsukage T.
        • Amoroso G.
        • Fraser D.
        • Claessen B.E.
        • et al.
        Focus on maximal miniaturisation of transradial coronary access materials and techniques by the Slender Club Japan and Europe: an overview and classification.
        EuroIntervention: journal of EuroPCR in collaboration with the Working Group on Interventional Cardiology of the European Society of Cardiology. Feb 2015; 10: 1178-1186https://doi.org/10.4244/eijy14m09_09
        • Chugh S.K.
        • Chugh Y.
        • Chugh S.
        How to tackle complications in radial procedures: tip and tricks.
        Indian Heart J. 2015/05/01/2015; 67: 275-281https://doi.org/10.1016/j.ihj.2015.05.016
        • Mamas M.A.
        • Fath-Ordoubadi F.
        • Fraser D.G.
        Atraumatic complex transradial intervention using large bore sheathless guide catheter.
        Cathet Cardiovasc Interv. 2008; 72: 357-364https://doi.org/10.1002/ccd.21637
        • From A.M.
        • Gulati R.
        • Prasad A.
        • Rihal C.S.
        Sheathless transradial intervention using standard guide catheters.
        Cathet Cardiovasc Interv. 2010; 76 (https://doi.org/10.1002/ccd.22742slke): 911-916https://doi.org/10.1002/ccd.22742
        • Mason P.J.
        • Shah B.
        • Tamis-Holland J.E.
        • Bittl J.A.
        • Cohen M.G.
        • Safirstein J.
        • et al.
        An update on radial artery access and best practices for transradial coronary angiography and intervention in acute coronary syndrome: a scientific statement from the American Heart Association.
        Circulation: Cardiovasc Interv. 2018; 11e000035https://doi.org/10.1161/HCV.0000000000000035
        • Larsen P.
        • Shah S.
        • Waxman S.
        • Freilich M.
        • Riskalla N.
        • Piemonte T.
        • et al.
        Comparison of procedural times, success rates, and safety between left versus right radial arterial access in primary percutaneous coronary intervention for acute ST-segment elevation myocardial infarction.
        Cathet Cardiovasc Interv. 2011; 78 (https://doi.org/10.1002/ccd.22843): 38-44https://doi.org/10.1002/ccd.22843