Coronary artery diseaseComparison of Access-Related Bleeding Complications in Women Versus Men Undergoing Percutaneous Coronary Catheterization Using the Radial Versus Femoral Artery
Section snippets
Methods
The primary study objective was to determine the incidence of in-hospital puncture-related major and minor hemorrhages. Secondary study objectives were to (1) identify predictors of major hemorrhage and (2) determine how often a second, alternative access site is required during radial procedures.
The study was performed in the Interventional Cardiology Unit of San Filippo Neri Hospital (Rome, Italy), a high-volume center performing >2,000 coronary procedures per year, with 35% of total activity
Results
During the observation period, 2,919 patients underwent 3,261 interventional and/or diagnostic procedures; 2,079 men underwent 2,361 procedures and 838 women underwent 900 procedures (1.1 procedures/patient in men and women). Overall, 1,703 of 3,261 (52%) RAC procedures were performed, but radial artery access was used less frequently in women than in men (299 of 900, 33%, vs 1,404 of 2,361, 59%, respectively, p <0.00001).
Table 1 presents a comparison of the women’s characteristics at the time
Discussion
Several previous randomized studies6 have demonstrated a dramatic decrease in entry site complications with RAC versus the traditional femoral artery approach. This prospective registry represents the largest published study on the influence of gender on arterial approach-rated complications. Our data show, for the first time in the “real world,” that RAC is associated with a lower incidence of major bleeds and up to an 84% decrease in minor bleeding in women, a high-risk population for
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