Mastering the antegrade femoral artery access in patients with symptomatic lower limb ischemia: learning curve, complications, and technical tips and tricks.

Mastering the antegrade femoral artery access in patients with symptomatic lower limb ischemia: learning curve, complications, and technical tips and tricks. Research Abstract Details 

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Mastering the antegrade femoral artery access in patients with symptomatic lower limb ischemia: learning curve, complications, and technical tips and tricks. Abstract Text:

Giuseppe G L Biondi-Zoccai,Pierfrancesco Agostoni,Giuseppe Sangiorgi,Luca Dalla Paola,Fabio Armano,Simone Nicolini,Josef Alek,Massimiliano Fusaro,

BACKGROUND: Antegrade femoral access is fraught by technical challenges and steeper learning curve, in comparison with retrograde contralateral femoral access. We appraised learning curve, complications, and technical aspects inherent in the adoption of antegrade approach. METHODS: Consecutive cases in which antegrade access was attempted by a cardiologist experienced in retrograde access, but inexperienced in antegrade, under supervision of an operator with anterograde expertise, were collected. The primary end-point was the occurrence of antegrade access failure or local complications. Major complications were defined as those life-threatening, requiring transfusion, percutaneous, or surgical repair. RESULTS: Anterograde access was attempted in 120 patients. The primary end-point occurred in 14 (11.6%) cases, but according to the learning curve, in 12 (20%) for first 60 cases vs 2 (3.3%) for the last 60 cases (P = 0.008). Access failure in the hands of the in-training operator was similarly found in all cases but one during the first 60 cases. No major complications occurred, while minor complications were found in 9 (7.5%) patients, again with all but two of them occurring in the first 60 cases. These included peri-adventitial extravasation in 8 patients (6.7%), and perforation of a small branch in one (0.8%); all these complications were conservatively and successfully managed. Obesity was the only significant predictor of access failure/complication (P = 0.004). CONCLUSIONS: This work, the first to report on the learning curve of the antegrade approach, supports the feasibility and safety of this access site even for an in-training operator, if supervised. A minimum caseload of 60 procedures is likely needed to master this technique.

Mastering the antegrade femoral artery access in patients with symptomatic lower limb ischemia: learning curve, complications, and technical tips and tricks. Publishing Authors By Initials

GG Biondi-Zoccai,P Agostoni,G Sangiorgi,L Dalla Paola,F Armano,S Nicolini,J Alek,M Fusaro,

For similar surgical procedures, operative: surgical procedures, minimally invasive research abstracts see: surgical procedures, operative: surgical procedures, minimally invasive research

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Mastering the antegrade femoral artery access in patients with symptomatic lower limb ischemia: learning curve, complications, and technical tips and tricks. Journal Published:

PUBLICATION TYPE: Journal Article

Journal: Catheterization and cardiovascular interventions :

VOLUME: 68

Page Numbers: 835-42

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ISSN: 1522-1946

DAY: 8

MONTH: Dec

YEAR: 2006

Mastering the antegrade femoral artery access in patients with symptomatic lower limb ischemia: learning curve, complications, and technical tips and tricks. Information

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LANGUAGE: eng

NlmUniqueID: 100884139

Mastering the antegrade femoral artery access in patients with symptomatic lower limb ischemia: learning curve, complications, and technical tips and tricks. Keywords Mesh Terms:

KEYWORDS: Surgical Procedures, Minimally Invasive

MESH TERMS: education

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Grant and Affiliation Information for Mastering the antegrade femoral artery access in patients with symptomatic lower limb ischemia: learning curve, complications, and technical tips and tricks.

AFFILIATION: Hemodynamics and Cardiovascular Interventions Service, Abano Terme Hospital, Abano Terme, Italy. gbiondizoccai@gmail.com

Country: United States

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MEDLINETA: Catheter Cardiovasc Interv

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