Transradial Access Strategy Provides Most Benefit for PCI-Related Bleeding

Compared with other bleeding avoidance strategies (BAS), transradial access (RAD) is the most effective for PCI-related bleeding according to poster research presented March 16 at ACC.19 in New Orleans, LA.

The research used real-world data from a large multi-state health system to evaluate the impact of BAS individually or in combination among patients undergoing PCI with varying levels of bleeding risk. The poster titled, “Differential Impact of Bleeding Avoidance Strategies on Risk-Adjusted PCI-Related Bleeding Rates Within a Large Multistate Health System,” is the first to report on the relative impact of RAD, bivalirudin (BIV) and vascular closure device (VCD) BAS across bleeding risk strata.

The results found, “raw PCI-related bleeding rates were 4.4 percent overall and 9.6 percent, 5.8 percent, 5.4 percent, 3.2 percent, 2.0 percent, and 1.7 percent in patients receiving no BAS, BIV, VCD, VCD + BIV, RAD, and RAD + BIV, respectively.” Therefore, if a single intervention is used, RAD is the preferred strategy. While adding BIV to a VCD significantly reduced bleeding, combining BIV and RAD strategies does not provide the same benefit.

Tyler J. Gluckman, MD, FACC, and co-authors noted, “further efforts should be directed at maximizing use of bleeding avoidance strategies, particularly among those at higher bleeding risk.”

ACC’s Reduce the Risk: PCI Bleed Quality Campaign provides hospitals with evidence-based best practices to minimize PCI-associated bleeding risks and save patient lives. The program is free for all hospitals participating in the CathPCI Registry.

Keywords: ACC19, ACC Annual Scientific Session, Vascular Closure Devices, Immunodeficiency Virus, Bovine, Hirudins, Peptide Fragments, Hemorrhage, Registries, Percutaneous Coronary Intervention

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