{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,20]],"date-time":"2026-10-20T18:39:48Z","timestamp":1792521588600,"version":"4.5.0"},"reference-count":25,"publisher":"Ovid Technologies (Wolters Kluwer Health)","issue":"10","content-domain":{"domain":["www.ahajournals.org"],"crossmark-restriction":true},"short-container-title":["Circ: Cardiovascular Interventions"],"published-print":{"date-parts":[[2026,10]]},"abstract":"<jats:sec>\n                    <jats:title>BACKGROUND:<\/jats:title>\n                    <jats:p>Randomized trials comparing radial and femoral access report access site crossover rates of 3% to 9% for radial access and 1% to 3% for femoral access. However, contemporary real-world crossover rates are not well characterized. The aim was to evaluate contemporary trends and predictors of vascular access site crossover during percutaneous coronary intervention (PCI).<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>METHODS:<\/jats:title>\n                    <jats:p>We analyzed index PCI procedures recorded in the National Cardiovascular Data Registry CathPCI (Catheterization and Percutaneous Coronary Intervention) Registry from 2018 to 2024. Access site crossover was identified using documented access data, with radial-to-femoral crossover inferred when the final successful access site was femoral. Temporal trends and clinical predictors of crossover were examined. Operator experience was assessed using cumulative total and radial PCI volumes from 2011 to 2024 as captured in CathPCI Registry versions 4 and 5.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>RESULTS:<\/jats:title>\n                    <jats:p>Among 3\u2009861\u2009790 index PCIs, 192\u2009902 (5.0%) involved access site crossover, with a modest increase over time. Radial-to-femoral crossover accounted for 81.2% of crossover events. Factors independently associated with crossover included older age, female sex, higher body mass index, and peripheral vascular disease. Operators with the lowest total PCI volume and the lowest radial PCI volume experienced the highest crossover rates. Notably, operators with low radial PCI volume demonstrated a substantial decline in radial-to-femoral crossover over the study period.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>CONCLUSIONS:<\/jats:title>\n                    <jats:p>In contemporary clinical practice, access site crossover rates are consistent with those reported in randomized trials. Although crossover occurs more frequently among lower-volume operators, rates decline with increasing operator experience, supporting the presence of a radial access learning curve and improvement in procedural performance over time.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1161\/circinterventions.126.016673","type":"journal-article","created":{"date-parts":[[2026,7,20]],"date-time":"2026-07-20T09:00:31Z","timestamp":1784538031000},"update-policy":"https:\/\/doi.org\/10.1161\/crossmarkpolicy","source":"Crossref","is-referenced-by-count":1,"title":["Temporal Trends and Predictors of Access Site Crossover During PCI in Contemporary Practice: A Report From the NCDR CathPCI Registry"],"prefix":"10.1161","volume":"19","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-4320-0366","authenticated-orcid":true,"given":"Eli","family":"Reynolds","sequence":"first","affiliation":[{"name":"Department of Internal Medicine (E.R.), New York University Langone Health."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-8872-8001","authenticated-orcid":true,"given":"Binita","family":"Shah","sequence":"additional","affiliation":[{"name":"Department of Medicine (Cardiology), VA New York Harbor Healthcare System (Manhattan Campus) and New York University School of Medicine (B.S., N.R.S.)."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0009-0003-6133-0820","authenticated-orcid":true,"given":"Angel","family":"Marks","sequence":"additional","affiliation":[{"name":"Duke Clinical Research Institute, Durham, NC (A.M., D.W., J.R.)."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0009-0009-3431-2014","authenticated-orcid":true,"given":"Daniel","family":"Wojdyla","sequence":"additional","affiliation":[{"name":"Duke Clinical Research Institute, Durham, NC (A.M., D.W., J.R.)."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-6823-2815","authenticated-orcid":true,"given":"Nathaniel R.","family":"Smilowitz","sequence":"additional","affiliation":[{"name":"Department of Medicine (Cardiology), VA New York Harbor Healthcare System (Manhattan Campus) and New York University School of Medicine (B.S., N.R.S.)."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-9841-2393","authenticated-orcid":true,"given":"Jennifer","family":"Rymer","sequence":"additional","affiliation":[{"name":"Duke Clinical Research Institute, Durham, NC (A.M., D.W., J.R.)."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-8525-8454","authenticated-orcid":true,"given":"Ian C.","family":"Gilchrist","sequence":"additional","affiliation":[{"name":"Dartmouth Hitchcock Medical Center Heart and Vascular Institute, Lebanon, NH (I.C.G.)."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-2713-0433","authenticated-orcid":true,"given":"Rajiv","family":"Gulati","sequence":"additional","affiliation":[{"name":"Department of Cardiovascular Medicine, Mayo Clinic, Rochester, MN (R.G.)."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-2914-0894","authenticated-orcid":true,"given":"Sunil V.","family":"Rao","sequence":"additional","affiliation":[{"name":"Leon H. 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