Comparative Analysis of Right vs. Left Radial Access in Percutaneous Coronary Intervention: Impact on Silent Cerebral Ischemia
Abstract
:1. Introduction
2. Materials and Methods
3. Results
4. Discussion
5. Conclusions
Author Contributions
Funding
Institutional Review Board Statement
Informed Consent Statement
Data Availability Statement
Conflicts of Interest
References
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Parameter | Left Radial Group (n = 98) | Right Radial Group (n = 99) | p |
---|---|---|---|
Age (year) | 61.4 ± 8.9 8.99 | 62.7 ± 8.6 8.65 | 0.307 |
Male, n (%) | 69 (70.4) | 68 (68.7) | 0.867 |
Smoking, n (%) | 49 (49.2) | 43 (44.8) | 0.393 |
Body mass index (kg/m2) | 28.7 ± 3.9 3.92 | 28.5 ± 3.9 3.93 | 0.666 |
Hypertension n (%) | 77 (78.6) | 81 (81.8) | 0.596 |
Diabetes n (%) | 43 (43.9) | 52 (52.5) | 0.255 |
Hyperlipidemia n (%) | 54 (55.1) | 52 (52.5) | 0.776 |
Prior MI n (%) | 21 (21.4) | 23 (23.5) | 0.864 |
LVEF, % | 54.8 ± 7.7 | 54.5 ± 7.4 | 0.803 |
Diagnosis at admission | 0.762 | ||
NSTE-ACS n (%) | 33 (33.7) | 31 (31.3) | |
CCS n % | 65 (66.3) | 68 (68.7) | |
Hemoglobin, g/dL | 13.7 ± 1.6 | 13.4 ± 1.7 | 0.252 |
Hematocrit, % | 40.2 ± 4.4 | 39.3 ± 4.4 | 0.150 |
GFR, mL/dk | 84.8 ± 22.6 | 80.1 ± 22.9 | 0.206 |
HbA1c, mg/dL | 6.8 ± 1.6 | 7 ± 1.6 | 0.077 |
Triglyceride, mg/dL | 185.2 ± 85.2 | 196.4 ± 117.5 | 0.529 |
Total Cholesterol, mg/dL | 185.3 ± 45.6 | 188 ± 41.1 | 0.417 |
HDL-Cholesterol, mg/dL | 41.0 ± 9.3 | 41.8 ± 10.4 | 0.586 |
LDL-Cholesterol, mg/dL | 108.4 ± 39.5 | 110.3 ± 40.9 | 0.712 |
Parameter | Left Radial Group (n = 98) | Right Radial Group (n = 99) | p |
---|---|---|---|
Contrast volume (mL) | 154.8 ± 47.6 | 161.5 ± 50.8 | 0.276 |
Procedure time (min) | 29.2 ± 11.7 | 31.4 ± 12.2 | 0.125 |
Fluoroscopy time (min) | 14.1 ± 6.8 | 14.4 ± 7.3 | 0.980 |
Number of catheter, n | 2.8 ± 0.6 | 2 ± 0.4 | <0.001 |
Total number of used materials, n | 6.7 ± 1.5 | 6.2 ± 1.7 | 0.012 |
Total stent length (mm) | 29.6 ± 13.6 | 29.3 ± 14.0 | 0.805 |
Predilatation, n (%) | 71 (72.4) | 73 (73.7) | 0.873 |
Postdilatation, n (%) | 52 (53.1) | 65 (65.7) | 0.083 |
Catheter type | 0.542 | ||
Judkins, n (%) | 33 (33.7) | 29 (29.3) | |
Non-Judkins, n (%) | 65 (66.3) | 70 (70.7) | |
SYNTAX score | 11.5 ± 6.7 | 10.4 ± 5.7 | 0.388 |
Target vessel | 0.772 | ||
LAD, n (%) | 38 (38.7) | 35 (35.4) | |
LCX, n (%) | 25 (25.5) | 27 (27.3) | |
RCA, n (%) | 28 (28.6) | 29 (29.3) | |
LAD + LCX, n (%) | 3 (3.1) | 4 (4) | |
LAD + RCA, n (%) | 1 (1) | 3 (3) | |
RCA + LCX, n (%) | 3 (3.1) | 1 (1) | |
Subclavian tortuosity | <0.001 | ||
Severe tortuosity (+), n (%) | 6 (6.1) | 23 (23.2) | |
Severe tortuosity (−), n (%) | 92 (93.9) | 76 (76.9) | |
P2Y12 | 0.955 | ||
Clopidogrel, n (%) | 74 (75.5) | 75 (75.8) | |
Ticagrelor, n (%) | 8 (8.2) | 9 (9.1) | |
Prasugrel, n (%) | 16 (16.3) | 15 (15.2) |
Parameter | SCI (−) (n = 137) | SCI (+) (n = 60) | p |
---|---|---|---|
Radial preference | 0.034 | ||
Left radial, n (%) | 75 (76.5) | 23 (23.5) | |
Right radial, n (%) | 62 (62.6) | 37 (37.4) | |
Age (year) | 62.2 ± 8.6 | 61.8 ± 9.2 | 0.790 |
Male, (n) % | (90) 65.7 | (47) 78.3 | 0.076 |
Body mass index (kg/m2) | 29.1 ± 4.1 | 27.6 ± 3.0 | 0.033 |
Hypertension, n (%) | 111 (81) | 47 (78.3) | 0.699 |
Diabetes, n (%) | 61 (44.5) | 34 (56.7) | 0.117 |
HbA1c, mg/dL | 6.7 ± 1.5 | 7.2 ± 1.7 | 0.031 |
Prior MI, n (%) | 30 (21.9) | 14 (23.3) | 0.824 |
Smoking, n (%) | 57 (41.6) | 35 (58.3) | 0.043 |
Hyperlipidemia n (%) | 70 (51.1) | 36 (60) | 0.249 |
Subclavian tortuosity, n (%) | 15 (10.9) | 14 (23.3) | 0.027 |
LVEF, % | 55.4 ± 7.1 | 52.9 ± 8.2 | 0.061 |
Contrast volume (mL) | 158.9 ± 50.5 | 155.3 ± 47.1 | 0.762 |
Procedure time (min) | 29.9 ± 11.8 | 31.1 ± 12.5 | 0.506 |
Total stent length (mm) | 30.4 ± 14.2 | 26.9 ± 12.5 | 0.108 |
Total number of used materials, n | 6.5 ± 1.7 | 6.3 ± 1.5 | 0.552 |
Parameter | Odds Ratio (OR) | %95 C.I. for OR | p | |
---|---|---|---|---|
Lower | Upper | |||
Right radial preference | 1.946 | 1.047–3.676 | 0.035 | |
Smoking | 0.713 | 0.524–0.970 | 0.031 | |
HbA1c | 1.195 | 0.997–1.432 | 0.051 | |
Male | 0.530 | 0.261–1.075 | 0.079 | |
Procedure time | 1.009 | 0.984–1.034 | 0.505 | |
Subclavian tortuosity | 0.341 | 0.153–0.763 | 0.009 | |
Total number of used materials | 0.924 | 0.766–1.114 | 0.406 | |
LVEF | 0.958 | 0.922–0.966 | 0.033 |
Parameter | Odds Ratio (OR) | 95% C.I. for OR | p | |
---|---|---|---|---|
Lower | Upper | |||
Right radial preference | 2.104 | 1.102–3.995 | 0.023 | |
Smoking | 2.088 | 1.105–3.944 | 0.023 | |
LVEF | 0.958 | 0.920–0.998 | 0.039 |
Risk Factor | AUC (95% C.I.) | p | Cut-Off Value | Sensitivity (%) | Specificity (%) |
---|---|---|---|---|---|
LVEF | 0.639 (0.551–0.809) | 0.007 | 51.5 | 40 | 73 |
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Kara, A.; Soylu, K.; Yildirim, U.; Uyanik, M.; Coksevim, M.; Avci, B. Comparative Analysis of Right vs. Left Radial Access in Percutaneous Coronary Intervention: Impact on Silent Cerebral Ischemia. Medicina 2024, 60, 1193. https://doi.org/10.3390/medicina60081193
Kara A, Soylu K, Yildirim U, Uyanik M, Coksevim M, Avci B. Comparative Analysis of Right vs. Left Radial Access in Percutaneous Coronary Intervention: Impact on Silent Cerebral Ischemia. Medicina. 2024; 60(8):1193. https://doi.org/10.3390/medicina60081193
Chicago/Turabian StyleKara, Abdulkadir, Korhan Soylu, Ufuk Yildirim, Muhammet Uyanik, Metin Coksevim, and Bahattin Avci. 2024. "Comparative Analysis of Right vs. Left Radial Access in Percutaneous Coronary Intervention: Impact on Silent Cerebral Ischemia" Medicina 60, no. 8: 1193. https://doi.org/10.3390/medicina60081193