title: Compared to femoral venous access, upper extremity right heart catheterization reduces time to ambulation: A single center experience.
abstract: OBJECTIVE
  To determine ambulation times after right heart catheterization (RHC) via upper extremity access compared to femoral venous access.
  
  
  BACKGROUND
  Transradial coronary angiography has been associated with shorter times to ambulation. We hypothesized that RHC from the upper extremity would be similarly associated with shorter ambulation times when compared to traditional femoral access.
  
  
  METHODS
  We performed a single-center retrospective analysis of 379 consecutive patients who underwent a variety of diagnostic and interventional left- and right-heart procedures through upper extremity and femoral access sites.
  
  
  RESULTS
  The time to ambulation for RHC through the arm veins versus the femoral vein was lower (42.6 min ± 14.2 vs. 175.0 min ± 65.0, P < 0.001). Fluoroscopy times (8.5 min ± 6.8 vs. 12.8 min ± 8.4, P < 0.001) and radiation doses (64.1 Gy cm-2± 60.0 vs. 108.5 Gy cm-2± 71.6, P < 0.001) were reduced in the radial compared to femoral group, respectively. In multivariate analyses, upper arm access (P < 0.0001), lower heparin dose (P = 0.032), inpatient status (P = 0.01), and concurrent PCI (P = 0.03) were associated with shorter times to ambulation.
  
  
  CONCLUSIONS
  Right heart catheterization from the upper extremity is strongly associated with shorter times to ambulation. © 2016 Wiley Periodicals, Inc.
authors.affiliation: Department of Veterans Affairs, Jesse Brown VA Medical Center, Chicago, Illinois.
authors.forename: Bernadette
authors.initials: B
authors.lastname: Speiser
authors.affiliation: Department of Veterans Affairs, Jesse Brown VA Medical Center, Chicago, Illinois.
authors.forename: Katrina
authors.initials: K
authors.lastname: Pearson
authors.affiliation: Division of Epidemiology and Biostatistics, University of Illinois at Chicago, Chicago, Illinois.
authors.forename: Hui
authors.initials: H
authors.lastname: Xie
authors.affiliation: Department of Veterans Affairs, Jesse Brown VA Medical Center, Chicago, Illinois.|Division of Epidemiology and Biostatistics, University of Illinois at Chicago, Chicago, Illinois.
authors.forename: Adhir R
authors.initials: AR
authors.lastname: Shroff
authors.affiliation: Department of Veterans Affairs, Jesse Brown VA Medical Center, Chicago, Illinois.|Division of Epidemiology and Biostatistics, University of Illinois at Chicago, Chicago, Illinois.
authors.forename: Mladen I
authors.initials: MI
authors.lastname: Vidovich
mesh_terms: D000368:Aged; D000553:Ambulatory Care / Q000639:trends*; D006328:Cardiac Catheterization / Q000379:methods*; D017023:Coronary Angiography / Q000379:methods; D005260:Female; D005268:Femoral Vein; D005471:Fluoroscopy; D006801:Humans; D008297:Male; D017534:Radial Artery; D015203:Reproducibility of Results; D012189:Retrospective Studies; D018497:Ventricular Dysfunction, Right / Q000175:diagnosis*
keywords: right heart catheterization; time to ambulation; upper extremity access