title: Predictors of Conversion from Radial Into Femoral Access in Cardiac Catheterization.
abstract: BACKGROUND
  Fewer bleeding complications and early ambulation make radial access a privileged route for cardiac catheterization. However, transradial (TR) approach is not always successful, requiring its conversion into femoral access.
  
  
  OBJECTIVE
  To evaluate the rate of conversion from radial into femoral access in cardiac catheterization and to identify its predictors.
  
  
  METHODS
  Prospective dual-center registry, including 7632 consecutive patients undergoing catheterization via the radial access between Jan/2009 and Oct/2012. We evaluated the incidence of conversion into femoral access and its predictors by logistic regression analysis.
  
  
  RESULTS
  The patients' mean age was 66 ± 11 years, and 32% were women. A total of 2969 procedures (38.4%) were percutaneous coronary interventions (PCI), and the most used first intention arterial access was the right radial artery (97.6%). Radial access failure rate was 5.8%. Independent predictors of conversion from radial into femoral access were the use of short introducer sheaths (OR 3.047, CI: 2.380-3.902; p < 0.001), PCI (OR 1.729, CI: 1.375-2.173; p < 0.001), female sex (OR 1.569, CI: 1.234-1.996; p < 0.001), multivessel disease (OR 1.457, CI: 1.167-1.819; p = 0.001), body surface area (BSA) ≤ 1.938 (OR 1.448, CI: 1.120-1.871; p = 0.005) and age > 66 years (OR 1.354, CI: 1.088-1.684; p = 0.007).
  
  
  CONCLUSIONS
  Transradial approach for cardiac catheterization has a high success rate and the need for its conversion into femoral access in this cohort was low. Female sex, older age, smaller BSA, the use of short introducer sheaths, multivessel disease and PCI were independent predictors of conversion into femoral access.
authors: Hospital de Santa Cruz, Portugal.
authors: Maria Salomé
authors: MS
authors: Carvalho
authors: Hospital de Santa Cruz, Portugal.
authors: Rita
authors: R
authors: Calé
authors: Hospital de Santa Cruz, Portugal.
authors: Pedro de Araújo
authors: Pde A
authors: Gonçalves
authors: Hospital de Santa Cruz, Portugal.
authors: Hugo
authors: H
authors: Vinhas
authors: Hospital de Santa Cruz, Portugal.
authors: Luís
authors: L
authors: Raposo
authors: Hospital de Santa Cruz, Portugal.
authors: Rui
authors: R
authors: Teles
authors: Hospital de Santa Cruz, Portugal.
authors: Cristina
authors: C
authors: Martins
authors: Hospital de Santa Cruz, Portugal.
authors: Henrique Mesquita
authors: HM
authors: Gabriel
authors: Hospital de Santa Cruz, Portugal.
authors: Helder
authors: H
authors: Pereira
authors: Hospital de Santa Cruz, Portugal.
authors: Manuel
authors: M
authors: Almeida
mesh_terms: D000367:Age Factors; D000368:Aged; D000369:Aged, 80 and over; D006328:Cardiac Catheterization / Q000009:adverse effects / Q000379:methods*; D005260:Female; D005263:Femoral Artery / Q000601:surgery; D006801:Humans; D008297:Male; D008875:Middle Aged; D062645:Percutaneous Coronary Intervention / Q000009:adverse effects / Q000379:methods; D011446:Prospective Studies; D017534:Radial Artery / Q000601:surgery; D012307:Risk Factors; D012737:Sex Factors; D018709:Statistics, Nonparametric; D013997:Time Factors; D016896:Treatment Outcome