DOI: 10.1161/circ.148.suppl_1.13387 ISSN: 0009-7322

Abstract 13387: Transradial Intervention in Dialysis Patients Undergoing Percutaneous Coronary Intervention: A Japanese Nationwide Registry Study

Toshiki Kuno, Kyohei Yamaji, Tadao Aikawa, Mitsuaki Sawano, Tomo Ando, Yohei Numasawa, Hideki Wada, Tetsuya Amano, Ken Kozuma, Shun Kohsaka
  • Physiology (medical)
  • Cardiology and Cardiovascular Medicine

Introduction: Transradial intervention (TRI) for percutaneous coronary intervention (PCI) is used to reduce periprocedural complications. However, its effectiveness and safety for patients on dialysis are not well established. Hence, we aimed to investigate the association of TRI with in-hospital complications in dialysis patients undergoing PCI.

Hypothesis: TRI reduces periprocedural complications for dialysis patients undergoing PCI.

Methods: We included 52,639 patients on dialysis who underwent PCI using Japanese nationwide PCI registry data (2019-2021). Patients were categorized based on access site: TRI, transfemoral intervention (TFI), or other access site. Periprocedural access site bleeding complication requiring transfusion was the primary outcome and in-hospital death and other periprocedural complications were the secondary outcomes. Matched weighted analysis was performed for TRI and TFI.

Results: Here, 8,267 (15.7%) underwent TRI, 36,195 (60.2%) underwent TFI, and 8,177 (15.5%) underwent PCI from other access sites. Patients who received TRI were older and had lower rates of comorbidities than those who received TFI. Access site bleeding rate and in-hospital death were significantly lower in the TRI group (0.1% versus 0.7%, P<0.001; 1.8% versus 3.2%, P<0.001, respectively). After adjustment, TRI was associated with a lower risk of access site bleeding (odds ratio [OR] [95% confidence interval (CI)]: 0.19 [0.099-0.38]; P <0.001) and in-hospital death (OR [95% CI]: 0.79 [0.65-0.96]; P=0.02). Other periprocedural complications between TRI and TFI were not significantly different.

Conclusions: In patients undergoing dialysis and PCI, TRI had a lower risk of access site bleeding and in-hospital death than TFI. This suggests that TRI may be safer for this patient population. Further investigation is necessary to promote the widespread utilization of TRI for patients on dialysis.

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