<section class="abstract ng-scope" id="hl0000754"> <h2 id="hl0000755">Abstract</h2> <h2 id="hl0000757">Background</h2> <p id="hl0000758">Percutaneous coronary intervention (PCI) is increasingly performed in patients with chronic kidney disease (CKD), including in end-stage renal disease (ESRD), however studies on vascular access are limited.</p> <h2 id="hl0000760">Objective</h2> <p id="hl0000761">We sought to describe vascular access choice and outcomes of PCI from transfemoral (TFA) compared to transradial access (TRA) in ESRD patients on dialysis.</p> <h2 id="hl0000763">Methods</h2> <p id="hl0000764">Patients with ESRD on dialysis undergoing PCI from October 2010 to January 2017 at two hospitals in a health system reporting to the National Cardiovascular Data Registry (NCDR) CathPCI registry as well as their respective electronic medical records (Epic) were analyzed. Baseline characteristics, procedural and in-hospital outcomes were compared according to access site, TFA versus TRA.</p> <h2 id="hl0000766">Results</h2> <p id="hl0000767">There were 270 patients with ESRD on dialysis who underwent PCI, 234 via the TFA and 36 via the TRA. Mean age of the patients was 67 and 67.4% were male. The TFA patients had a lower body-mass-index (BMI) (<span> </span><i>P</i><span> </span>< 0.001) and were more likely to have prior coronary artery bypass graft (CABG) (P < 0.001) and PCI of the left main coronary artery (LM) (<span> </span><i>P</i><span> </span>= 0.04). Access site cross over only occurred in one patient in each group. Bleeding within 72 h was seen in 3.8% of the TFA group and in 2.8% of the TRA group (<span> </span><i>P</i><span> </span>= 0.75).</p> <h2 id="hl0000772">Conclusion</h2> <p id="hl0000773">Use of TRA is uncommon in patients with ESRD on dialysis, but is feasible and associated with low complication rates, similar to TF.</p> <h2 id="hl0000775">Summary for the annotated table of contents</h2> <p id="hl0000776">While PCI is being increasingly performed in patients with end-stage renal disease, there are is a lack of data on vascular access for this group. This study shows that while a transradial approach TRA is less common than transfemoral (TFA), it is still a feasible option and is associated with low complications similar to TFA.</p> </section> <section class="abstract ng-scope" id="hl0000777"> <h2 id="hl0000778">Highlights</h2> <ul id="hl0000781" class="c-content-list"> <li id="hl0000782">Transfemoral approach was more common than the transradial in dialysis patients.</li> <li id="hl0000785">Access site crossover was rare occurring in only one patient in each group.</li> <li id="hl0000788">Bleeding rates were similar between the transfemoral and transradial approach.</li> </ul> </section>