Percutaneous brachial artery access for coronary artery procedures: Feasible and safe in the current era

• Published in: Cardiovascular revascularization medicine Vol. 16; no. 8; pp. 447 - 449
• Main Authors: Parviz, Yasir, Rowe, Rebecca, Vijayan, Sethumadhavan, Iqbal, Javaid, Morton, Allison C, Grech, Ever D, Hall, Ian, Gunn, Julian
• Format: Journal Article
• Language: English
• Published: United States Elsevier Inc 01-12-2015
• Subjects: Aged; Aged, 80 and over; Angioplasty, Balloon, Coronary - adverse effects; Angioplasty, Balloon, Coronary - methods; Brachial Artery; Cardiovascular; Catheterization, Peripheral - adverse effects; Catheterization, Peripheral - methods; Cohort Studies; Complications; Coronary Angiography - methods; Coronary Artery Disease - diagnostic imaging; Coronary Artery Disease - mortality; Coronary Artery Disease - therapy; Coronary Circulation - physiology; Coronary intervention; Feasibility Studies; Female; Follow-Up Studies; Hospital Mortality - trends; Humans; Male; Middle Aged; Patient Safety - statistics & numerical data; Percutaneous Coronary Intervention - adverse effects; Percutaneous Coronary Intervention - methods; Retrospective Studies; Risk Assessment; Survival Rate; Treatment Outcome; United Kingdom; Vascular access; Complications; Coronary intervention; Vascular access
• DOI: 10.1016/j.carrev.2015.08.004
• EISSN: 1878-0938
• ISSN: 1553-8389

Abstract Background Percutaneous vascular access for coronary intervention is currently achieved predominately via the radial route, the femoral route acting as a backup. Percutaneous trans-brachial access is no longer commonly used due to concerns about vascular complications. This study aimed to investigate the safety and feasibility of percutaneous brachial access when femoral and radial access was not possible. Methods This is a retrospective data analysis of patients who attended a single tertiary cardiology centre in the UK between 2005 and 2014 and had a coronary intervention (coronary angiogram or PCI) via the brachial route. The primary endpoints were procedural success and the occurrence of vascular complications. Results During the study period 26602 patients had a procedure (15655 underwent PCI and 10947 diagnostic angiography). Of these, 117 (0.44% of total) had their procedure performed via the brachial route. The procedure was successful in 96% (112/117) of cases. 13 (11%) patients experienced post procedural complications, of which 2 (1.7%) were serious. There were no deaths. Conclusion Percutaneous trans-brachial arterial access is feasible with a high success rate and without evidence of high complication rate in a rare group of patients in whom femoral or sometimes radial attempts have failed.