Abstract 224: Neurological Complications Following Cardiac Catheterization During Transition From Femoral Access To Radial And Femoral Access

Abstract

Background: Prior data has shown that radial approach has been associated with increased rate of cerebral emboli. During transition from femoral access site (historical) to a combined radial and femoral access site (contemporary) for cardiac catheterization, we hypothesize that increased manipulation of equipment would be associated with greater manipulation of the aorta and result in increased embolic events to the brain. Our study investigates whether the rate of neurologic events changed from historical to contemporary time periods. Methods: A retrospective chart review was conducted to assess all cardiac catheterization cases performed at a large tertiary care academic center from 2007-2009 (historical n = 9776) and from 2010-2011 (contemporary n = 5294). A cerebrovascular accident (CVA) is defined as a documented central neurologic deficit persisting for at least 24 hours and a transient ischemic attack (TIA) as a neurologic event with the signs and symptoms of a CVA but which goes away within a short period of time. Results: The historical group had equivalent mean age (p=0.1), percentage female patients (p=0.13), history of cerebrovascular disease (p=0.62) and hyperlipidemia (p=0.08) as compared to the contemporary group. The historical group had lower rate of diabetes (37.4% vs 41.6%, p<0.01) and hypertension (82.1% vs 84.1%, p<0.01) but higher rate of renal failure (6.1% vs 4.8%, p<0.01) as compared to contemporary group. The historical group utilized femoral access significantly more than contemporary group (99.5% vs 79.6%, p<0.001). The historical group had equivalent CVA/TIA rate as contemporary group (0.02% vs 0.09%, p=0.056). Conclusion: Our single-center, retrospective study shows that during a period of transition to the radial artery access site for cardiac catheterization does not significantly change the rate of neurologic complications.