Are Neurologic Complications Following Percutaneous Coronary Angiography or Intervention More Common in Transfemoral versus Transradial Approach?

1. Are neurologiccomplicationsfollowingpercutaneouscoronaryangiographyorintervention more common in transfemoral versus transradialapproach? Helena Tizón-Marcos, Gérald R. Barbeau, Jean-Pierre Déry, Jacques R. Rouleau, Louis Roy, OnilGleeton, Jean-RochBoudreault, Guy Proulx, Olivier F. Bertrand, Can Mahn Nguyen, Bernard Noël, JosepRodés-Cabau, Eric Larose, StéphaneRinfret and Robert Delarochellière. InstitutUniversitaire de Cardiologie et Pneumologie de Québec. Québec, Canada.

2. Are neurologiccomplicationsfollowingpercutaneouscoronaryangiographyorintervention more common in transfemoral versus transradialapproach? Nothingtodisclose.

4. Timingafterangiographyor PCI in whichtheeventoccurs

5. typeofprocedure.

6. Are neurologiccomplicationsfollowing percutaneous coronaryangiographyorintervention more common in transfemoral versus transradialapproach? Factorsassociatedwith NC followingcoronaryangiographyorprocedureshavebeenwelldescribed. Transradialapproach has lowerhemorrhagic and vascular complicationratesbutitsvaluetolower NC followingdiagnosticcatheterizationor PCI has notbeenyetestablished. .

7. Are neurologiccomplicationsfollowing percutaneous coronaryangiographyorintervention more common in transfemoral versus transradialapproach? Objective Determine the incidence and different characteristics of neurologic complications following transradial and transfemoral approach.

8. Are neurologiccomplicationsfollowing percutaneous coronaryangiographyorintervention more common in transfemoral versus transradialapproach? Methods Retrospectivereview of allpatientswhounderwentcoronaryangiographyorinterventionbetweenApril 1990 and October 2007 at InstitutUniversitaire de Cardiologie et Pneumologie Québec. The complete chart of allpatientsdischargedwith a diagnostic of strokeortransientischemicattackwerereviewedextensively. All patients who experienced a per-procedural neurologic complication were included in the present analysis. Patients who developed neurological symptoms after by-pass surgery were excluded.

10. Depending on variable distribution, Student’s t-test or Wilcoxon rank-sum test were used to assess differences in continuous variables.

12. Stroke: anynewneurologicalsignorsymptomthatlasted more than 24 hoursaftertheonsetofsymptoms.

14. Diagnostictransradial: 70 UI/kgofunfractionedheparin.

16. 31391 coronaryinterventionNeurologiccomplicationsoccurred in 63 patients. Theoverallincidenceof NC is 0.075%

17. Are neurologiccomplicationsfollowingpercutaneouscoronaryangiographyorinterventions more common in transfemoral versus transradialapproach? Numberoftreatedpatientsperyearandincidenceof NC peryear

20. Are neurologiccomplicationsfollowing percutaneous coronaryangiographyorintervention more common in transfemoral versus transradialapproach?Baselinecharacteristics

21. Are neurologiccomplicationsfollowingpercutaneouscoronaryangiographyorinterventions more common in transfemoral versus transradialapproach?Baselinecharacteristics

22. Are neurologiccomplicationsfollowingpercutaneouscoronaryangiographyorinterventions more common in transfemoral versus transradialapproach?Procedural data

23. Are neurologiccomplicationsfollowingpercutaneouscoronaryangiographyorinterventions more common in transfemoral versus transradialapproach?Procedural data Peri-proceduralcomplication : Ventricular tachycardiaorfibrillation, complete atrioventricular block, heartfailurerequiringintervention, endotrachealurgentintubation and coronaryembolization.

24. Are neurologiccomplicationsfollowingpercutaneouscoronaryangiographyorinterventions more common in transfemoral versus transradialapproach?NC Data

26. Single-centre experience

27. Lackofrandomisation

29. Compared to transfemoral approach, transradial approach is associated with an unadjusted lower incidence of per-procedural NC.

30. Differences in NC rates may be explained by a higher rate of vein graft procedures in the transfemoral group or by routine heparin use in the transradial group.

32. Factors predicting neurological complications following percutaneous coronary angiography and interventions in a large series of transfemoral and transradial approach Methods 83409 procedures from April 1990 to October 2007 63 patients with discharge diagnosis of: Stroke CVA TIA Visual disturbances Intracranial haemorrhage 83346 patients without discharge diagnosis of Neurological haemorrhage Control group of 254 patients matched by date of procedure.