Femoral approach for coronary arteriography was associated with a higher mortality rate (0.78%) than the brachial approach (0.13%), and mortality was 8 times higher in low-volume centers.
Observational (n=46,904)
Yes
Does the arterial approach and institutional volume affect the complication rates of coronary arteriography?
Coronary arteriography complication rates are significantly influenced by institutional volume and the arterial approach used, with higher mortality observed in low-volume centers and with the femoral approach.
Absolute Event Rate: 0.78% vs 0.13%
A nationwide survey was undertaken to determine the rate of complications due to coronary arteriography during 1970-71. The responses from 173 hospitals-including a total of 46,904 coronary arteriograms-were analyzed in relationship to the technique employed and to the number of examinations performed at each hospital during the two-year period. The overall mortality rate was 0.45% (brachial 0.13%, femoral 0.78%). The mortality rate in institutions performing fewer than 200 examinations per two years was eight times higher than in institutions performing more than 800 examinations per two years. Similarly, the incidence of myocardial infarction and cerebral embolism was significantly higher when a smaller number of examinations was performed. The incidence of major complications-including death, myocardial infarction, and cerebral embolism-was higher in examinations using the femoral approach than the brachial approach. The incidence of arterial thrombosis and contrast agent reactions was higher for the brachial approach. Factors which may help to explain these differences are considered and discussed.
Adams et al. (Sat,) conducted a observational in Patients undergoing coronary arteriography (n=46,904). Femoral approach for coronary arteriography vs. Brachial approach was evaluated on Mortality rate. Femoral approach for coronary arteriography was associated with a higher mortality rate (0.78%) than the brachial approach (0.13%), and mortality was 8 times higher in low-volume centers.