Radial versus Femoral Access: RIVAL Objective:is radial access superior to femoral access Study:randomised, parallel group, multicenter trial Population:patients.

Slides:

Advertisements

Similar presentations

SHARP trial Study of Heart and Renal Protection : a randomised placebo-controlled trial The e ﬀ ects of lowering LDL cholesterol with simvastatin plus.

Advertisements

A randomized comparison of RadIal Vs. femorAL access for coronary intervention in ACS (RIVAL) SS Jolly, S Yusuf, J Cairns, K Niemela, D Xavier, P Widimsky,

A randomized comparison of RadIal Vs. femorAL access for coronary intervention in ACS (RIVAL) SS Jolly, S Yusuf, J Cairns, K Niemela, D Xavier, P Widimsky,

Timing of Intervention in Patients with Acute Coronary Syndromes (TIMACS) AHA, 2008.

Trans-Radial Interventions

Montalescot G et al. Lancet 2008;372:1-9. Mid- and long-term outcomes of STEMI patients treated with prasugrel, compared with clopidogrel and undergoing.

Radial versus Femoral Randomized Investigation in ST Elevation Acute Coronary Syndrome the RIFLE STEACS study Enrico Romagnoli, MD PhD Principal investigators:

CAPRIE: Clopidogrel versus Aspirin in Patients at risk of Ischemic Events Purpose To assess the relative efficacy of the antiplatelet drugs clopidogrel.

Gregg W. Stone MD for the ACUITY Investigators Gregg W. Stone MD for the ACUITY Investigators A Prospective, Randomized Trial of Bivalirudin in Acute Coronary.

RADIAL VS FEMORAL ACCESS FOR CORONARY ANGIOGRAPHY AND INTERVENTION IN PATIENTS WITH ACS-( RIVAL) A RANDOMIZED,PARALLEL GROUP, MULTICENTRE TRIAL.

Efficacy and safety of apixaban compared with warfarin at different levels of INR control for stroke prevention in atrial fibrillation.

FAME 2 year Objective:To investigate the 2-year outcome of PCI guided by FFR in patients with multivessel CAD. Study:Multicenter, single blind, randomized.

Giuseppe Biondi-Zoccai Division of Cardiology, University of Turin, Turin, Italy.

Primary PCI Treatment of choice for Acute MI.

CURE: Prior Stroke or TIA OutcomeC + ASAASAHRP value MI/stroke/ CV death 49/274 (17.9%)52/232 (22.4)0.74 (0.50, 1.10)0.13 Non-CABG TIMI major bleeding.

Percutaneous Repair or Surgery for Mitral Regurgitation EVEREST II Objective:to compare the efficacy of percutaneous implantation of a clip and conventional.

Radial versus Femoral Approach for Percutaneous Coronary Procedures: A Meta-analysis of Randomized Trials 6th EUROPEAN WORKSHOP ON TRANSRADIAL APPROACH.

TRI vs TFI in STEMI Shenyang Northern Hospital Wang Shouli Han Yalin.

Objective:To assess the effect of various clopidogrel and aspirin regimens on major CV events and ST in ACS patients undergoing PCI. Study:Multicenter,

Stents versus Bypass Surgery for Left Main disease Objective:to assess the non-inferiority of stents compared to bypass surgery for unprotected left main.

ARISTOTLE Objectives Primary: test for noninferiority of apixaban, a novel oral direct factor Xa inhibitor, versus warfarin Secondary: test for superiority.

Lancet 373: , 2009 Baseline Characteristics of Participants and Study Design of Clinical Trials to Compare Intensive glucose- lowering versus.

Safety and Efficacy of Intravenous Enoxaparin in Elective Percutaneous Coronary Intervention: an International Randomized Evaluation (STEEPLE) Presented.

A randomized comparison of RadIal Vs. femorAL access for coronary intervention in ACS (RIVAL) SS Jolly, S Yusuf, J Cairns, K Niemela, D Xavier, P Widimsky,

CABG versus PCI for Lmain/3 V-D: SYNTAX trial 3 year

Harmonizing Outcomes with RevascularIZatiON and Stents (HORIZONS) Trial HORIZONS Trial.

Disclosure Statement of Financial Interest

Bernardo Cortese, MD, FESC Intv’ Cardiology, A.O. Fatebenefratelli MI CNR-Fondazione Monasterio-Regione Toscana bernardocortese.com.

Date of download: 6/3/2016 From: Radial Versus Femoral Access in Invasively Managed Patients With Acute Coronary Syndrome: A Systematic Review and Meta-analysis.

Radial Access: Lots of Publicity, But What is the Reality?

Pros and Cons of Radial Access

What´s New in the Literature on Transradial Intervention

Volume 385, Issue 9985, Pages (June 2015)

PRAGUE-18 Trial design: Patients with STEMI undergoing primary PCI were randomized to prasugrel (n = 634) versus ticagrelor (n = 596). Results (p = 0.94)

CARIN Trial design: Patients undergoing coronary angiography were randomized in a 1:1:1:1 fashion to CMX mg/kg, 3.6 mg/kg, 4.8 mg/kg, or placebo.

Why Radial Access Should be the Default for Women undergoing PCI?

SOCRATES Trial design: Patients with acute ischemic stroke were randomized in a 1:1 fashion to receive either ticagrelor 180 mg load + 90 mg BID or aspirin.

Radial vs Femoral Access in ACS Patients

Adjusted odds ratio 95% CI Diagnostic angiography PCI CABG

Updates in Anticoagulation: What Did We Learn From ESC 2017?

Achieving Long-Term Protection Post-MI

Disclosures. Evaluating Recent Clinical Trial Data in the Secondary Prevention of ACS.

EUCLID Trial design: Patients with peripheral arterial disease (PAD) were randomized to ticagrelor 90 mg twice daily (n = 6,930) vs. clopidogrel 75 mg.

Compare-Acute Trial design: STEMI patients undergoing primary PCI were randomized to fractional flow reserve (FFR)-guided complete revascularization (n.

European Society of Cardiology 2003

ANTARCTIC Trial design: Patients with acute coronary syndrome undergoing stenting were randomized to tailored antiplatelet therapy (n = 435) versus conventional.

BASKET-PROVE II Trial design: Subjects with stable or unstable coronary artery disease undergoing stent implantation were randomized to a biodegradable-polymer.

ISAR-SAFE Trial design: Patients with DES PCI received 6 months of open-label DAPT with aspirin and clopidogrel. At 6 months, they were randomized in a.

NIPPON Trial design: Patients undergoing percutaneous coronary intervention were randomized to short-term dual antiplatelet therapy (DAPT) (6 months; n.

TRIAL HIGHLIGHT FROM ESC 2016: ACUTE CORONARY SYNDROMES

% Heparin + GPI IIb/IIIa Bivalirudin +

After Eighty Study Trial design: Elderly patients with non–ST-elevation acute coronary syndrome (NSTE-ACS) were randomized to invasive therapy (n = 229)

RIDDLE-NSTEMI Trial design: Patients with NSTEMI were randomized to either immediate (within 2 hours) intervention or delayed (within 72 hours) intervention.

(p < for noninferiority)

One-year clinical outcomes in older patients with non-ST elevation acute coronary syndrome undergoing coronary angiography: An analysis of the ICON1 study

BRAVO-3 Trial design: Patients undergoing transfemoral TAVR were randomized in a 1:1 fashion to bivalirudin or UFH. They were followed for 30 days. Results.

Ezetimibe/simvastatin

(p = for noninferiority)

Elevated Admission Plasma Glucose Following ACS

Volume 385, Issue 9985, Pages (June 2015)

Comparison of radial versus femoral access in patients undergoing invasive management for acute coronary syndromes: evidence from a systematic review and.

A randomized comparison of RadIal Vs

Cause of death Treatment-arm events, % (n=45 054)

SOLID-TIMI 52 Trial design: Participants within 30 days of an acute coronary syndrome (ACS) were randomized to darapladib 160 mg daily (n = 6,504) versus.

OPTIDUAL Trial design: Patients who received a drug-eluting stent and were event-free at 12 months were randomized to an additional 36 months of DAPT with.

IVUS-XPL Trial design: Patients undergoing drug-eluting stent implantation for long coronary lesions were randomized to IVUS-guided PCI (n = 700) vs. angiography-guided.

PROSPER: trial design

MATRIX: Radial vs. Femoral

FIELD: Primary outcome

Adjusted. ORs for outcomes by maintenance P2Y12 treatment

Presentation transcript:

Radial versus Femoral Access: RIVAL Objective:is radial access superior to femoral access Study:randomised, parallel group, multicenter trial Population:patients with ACS, undergoing coronary angiography with possible intervention Endpoint:composite of death, MI, stroke, non-CABG major bleeding at 30 days Objective:is radial access superior to femoral access Study:randomised, parallel group, multicenter trial Population:patients with ACS, undergoing coronary angiography with possible intervention Endpoint:composite of death, MI, stroke, non-CABG major bleeding at 30 days

Radial versus Femoral Access: RIVAL

Conclusion radial and femoral approaches are both safe and effective Conclusion radial and femoral approaches are both safe and effective Jolly Lancet 2011;377: