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Why set up a transradial approach program?

Why set up a transradial approach program?. Background and EBM in TRI Christian Pristipino, MD, FESC, FACC San Filippo Neri Hospital, Rome, Italy. MORE COMFORTABLE. Patient QOL 1 week after. Cooper et al, Am Heart J, 1999. Patient preference. HEMORRHAGES REDUCTION.

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Why set up a transradial approach program?

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  1. Why set up a transradial approach program? • Background and EBM in TRI • Christian Pristipino, MD, FESC, FACC • San Filippo Neri Hospital, Rome, Italy

  2. MORE COMFORTABLE

  3. Patient QOL 1 week after Cooper et al, Am Heart J, 1999

  4. Patient preference

  5. HEMORRHAGES REDUCTION

  6. Real World - PREVAIL study Pristipino et al; Heart 2009

  7. Real World - PREVAIL study Pristipino et al, Heart, 2009

  8. - S. Filippo Registry - Major bleedings - 3265 procedures p<0.00001 Pristipino et al, TCT meeting, 2008

  9. - S. Filippo Registry - Multivariate analysis Pristipino et al, Am J Cardiol, 2007

  10. ACC - NCDR593,094 procedures Rao et al, JACC Intv, 2009

  11. RIVIERA STUDY Montalescot et al, Int J Cardiol, 2008

  12. Metaanalysis RND studies Jolly et al, Am Heart J, 2009

  13. BETTER OUTCOMES

  14. PREVAIL study Pristipino et al, Heart, 2009

  15. M.O.R.T.A.A.L. study Chase et al, Heart, 2008

  16. RIVIERA study Montalescot et al, Int J Cardiol, 2008

  17. PRESTO-ACS sub-study Sciahbasi et al, Am J Cardiol, 2009

  18. Metaanalysis RND studies Jolly et al, Am Heart J, 2009

  19. OPTIMAL FEASIBILITY

  20. 94% 96% 96% 92% Success in the real world 2003 2006 Pristipino et al, Heart, 2009 Pristipino et al, Am J Cardiol, 2007

  21. ACC - NCDR593,094 procedures Rao et al, JACC Intv, 2009

  22. METAREGRESSION Radial 6.9% vs. Femoral 2.1%; OR: 3.45; p<0.004 After 1999: 3.9% vs. 2.9%, p=0.3 Agostoni et al, JACC, 2004

  23. ROLE OF THE EXPERTISE Pristipino et al, Eurointervention, 2010

  24. RAC failure predictors Pristipino et al, Eurointervention, 2010

  25. p=0.01 p=NS 107 cGy 672 sec 645 sec 84 cGy X-RAY EXPOSITION 2003 2006

  26. IMPROVEMENT OF LOGISTICS

  27. Hospital stay

  28. Hospital stay

  29. Hospital stay Cooper et al, Am Heart J, 1999

  30. EBM CONCLUSIONS • TRI ARE MORE CONFORTABLE THAN FEMORAL APPROACH • TRI ARE ASSOCIATED WITH BETTER OUTCOMES THAN FEMORAL APPROACH • A ROUTINE TRI STRATEGY LEADS TO OPTIMAL FEASIBILITY • TRI ALLOW IMPROVED LOGISTICS (COST SAVINGS)

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