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Comparative Study of the Radial and Femoral Artery Approaches for Diagnostic Coronary Angiography

Overview
Specialty General Medicine
Date 2011 Apr 22
PMID 21509310
Citations 6
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Abstract

Objectives: Femoral artery access is the standard approach for coronary procedures; however, the radial approach has gained sound recognition as an alternative to femoral access. We present our early experience with the transradial approach.

Methods: A prospective, non-randomised study of 221 candidates for diagnostic coronary angiography was carried out at Sultan Qaboos University Hospital, Oman between December 2008 and April 2009. The patients had their procedure performed from radial or femoral access according to operator discretion and the results were compared. Femoral and radial groups included 116 and 105 patients respectively.

Results: Radial access was associated with a significantly higher rate of procedural failure (17.1%) versus 0% in femoral group (p = 0.001). There were no local vascular complications in the radial group as opposed to 12.1% in the femoral group (p < 0.01). Hospital length of stay was significantly reduced in the radial group (4.06 versus 23.5 hours, p < 0.01). Total procedure time was longer in the radial group (23.7 ± 13.7 min versus 20.1 ± 7.4 min, p < 0.001), but radiation exposure was similar in both groups. There was a trend for a higher risk of major adverse cardiac events noticed in the femoral group; however, it did not reach statistical significance.

Conclusion: The transradial approach for coronary angiography is associated with significantly reduced local vascular complications and shorter hospital stays. The femoral approach is the standard access site for coronary angiography; however, interventional cardiologists should acquire experience in the radial approach as an alternative in specific situations.

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References
1.
Goldberg S, Renslo R, Sinow R, French W . Learning curve in the use of the radial artery as vascular access in the performance of percutaneous transluminal coronary angioplasty. Cathet Cardiovasc Diagn. 1998; 44(2):147-52. DOI: 10.1002/(sici)1097-0304(199806)44:2<147::aid-ccd5>3.0.co;2-6. View

2.
Mann 3rd , Cubeddu , Schneider , Arrowood . Right Radial Access for PTCA: A Prospective Study Demonstrates Reduced Complications and Hospital Charges. J Invasive Cardiol. 1996; 8 Suppl D:40D-44D. View

3.
Campeau L . Entry sites for coronary angiography and therapeutic interventions: from the proximal to the distal radial artery. Can J Cardiol. 2001; 17(3):319-25. View

4.
Applegate R, Sacrinty M, Kutcher M, Kahl F, Gandhi S, Santos R . Trends in vascular complications after diagnostic cardiac catheterization and percutaneous coronary intervention via the femoral artery, 1998 to 2007. JACC Cardiovasc Interv. 2009; 1(3):317-26. DOI: 10.1016/j.jcin.2008.03.013. View

5.
SCANLON P, Faxon D, Audet A, Carabello B, Dehmer G, Eagle K . ACC/AHA guidelines for coronary angiography: executive summary and recommendations. A report of the American College of Cardiology/American Heart Association Task Force on Practice Guidelines (Committee on Coronary Angiography) developed in.... Circulation. 1999; 99(17):2345-57. DOI: 10.1161/01.cir.99.17.2345. View