Risk factors of failed transradial approach for percutaneous coronary interventions in Chaoshan Chinese: a locally retrospective analysis.

BACKGROUND Transradial approach PCI reduces vascular complications compared with a transfemoral approach (TFA). TRA-PCI failure has been reported in 5-10% of cases. Reported studies showed that age > 75 years, previous CABG, short stature, female sex, and cardiogenic shock were independent predictors of TRA-PCI failure. However, related risk factors and causes of TRA-PCI failure are not well characterized, especially among Asians. OBJECTIVES To explore the risk factors and causes of transfemoral approach (TRA)-PCI failure in Chaoshan area. METHODS We retrospectively analyzed our databases for all patients who underwent TRA-PCI from January 2011 to June 2014 in the First Affiliated Hospital of Shantou University Medical College. Univariate and multivariate analyses were performed to determine independent risk factors of TRA-PCI failure and the causes of TRA-PCI failure. RESULTS A total of 1,276 patients underwent TRA-PCI. From univariate analyses, patients in the TRA-PCI failure group were significantly in women, and more likely to be age > 75 years compared with TRA-PCI success group. Besides, patients in the TRA-PCI failure group were significantly more likely to suffer from left main coronary disease, more heparin dose, longer fluoroscopy time, and more PCI procedural failure compared with the TRA-PCI successful group. From multivariate analysis, female and age > 75 years were independent predictors of TRA-PCI failure. The causes of TRA-PCI failure included unsuccessful radial artery puncture in 34, vascular anomaly in 54, and the problems of guide catheter and guide wire in 26 patients. CONCLUSIONS Being female and age > 75 years were independent risk factors of TRA-PCI failure. TRA-PCI failures indicated more possibility to suffer from left main coronary disease. The causes of TRA-PCI failure were complicated, among of those vascular abnormalities was an important factor.