Radial crossover refers to switch from the preferred radial to femoral artery for vascular access in a patient with an acute coronary syndrome (ACS). Gragnano et al reported a nomogram to predict the need for such a switch. The authors are from multiple institutions in Europe.
Patient selection: acute coronary syndrome (ACS)
Parameters:
(1) current smoker
(2) type of ACS
(3) Killip class
(4) history of previous coronary artery bypass graft (CABG)
(5) Center's percent of radial PCI's
(6) height in meters, from 1.3 to 2 meters
(7) history of renal failure
(8) age in years, from 20 to 100 years
points for height from 1.4 to 2 =
= 46.92 - (23.44 * (height))
For height of 1.3 meters the point assignment is 15.3
points for age =
= (0.325 * (age)) - 6.5
|
Parameter
|
Finding
|
Points
|
|
current smoker
|
no
|
5.2
|
|
|
yes
|
0
|
|
type of ACS
|
STEMI
|
6.4
|
|
|
non-STEMI
|
0
|
|
Killip class
|
I
|
0
|
|
|
II, III, IV
|
6.4
|
|
history of CABG
|
no
|
0
|
|
|
yes
|
10.2
|
|
proportion of radial PCI
|
80-98%
|
0
|
|
|
65-79%
|
4.9
|
|
|
15-64%
|
13.5
|
|
history of renal failure
|
no
|
0
|
|
|
yes
|
16.6
|
total score =
= SUM(points for all of the parameters)
Interpretation:
• minimum score: 0
• maximum score 99.6
percent crossover =
= (0.00000181852 * ((score)^3)) - (0.0000925159 * ((score)^2)) + (0.00218728 * (score)) - 0.00926667
