A Retrospective Study on the Use of Transradial Versus Transfemoral Approach for Coronary Angiography and Intervention at a Tertiary Hospital

Abstract

OBJECTIVES: The aim of this study is to analyze and compare femoral versus radial access for coronary angiography and intervention at the Cardiac Catheterization Laboratory of The Medical City, a tertiary hospital in the Philippines, from October 2010 to January 2011. METHODOLOGY: This is a retrospective study of all patients who underwent coronary angiography with or without intervention. Medical records of identified patients were reviewed to determine, analyze and compare the baseline characteristics, course, outcome and complications of the two groups. RESULTS: A total of 231 coronary procedures were performed on 219 patients, with 141 (61.04%) utilizing the radial artery for vascular access compared to 90 (38.96%) for the femoral artery. The overall success rate at first attempt to vascular access was 95.24%, with failure rate to vascular access of 7.28% and 1.25% in the radial and femoral group, respectively. The cross-over rate from radial to femoral access was 4.33%. Procedural success rates for percutaneous coronary intervention (PCI) were 100% and 95.45% for radial and femoral access, respectively. Arterial access was obtained with a significantly smaller introducer sheath in the radial compared to the femoral group in both coronary angiography (5.55 mm vs. 6.05 mm, respectively; p<0.000) and PCI procedures (5.86 mm vs. 6.36mm, respectively; p<0.000). Amount of contrast used and procedural time were similar between the two groups. Fluoroscopy time was significantly longer in the radial (39.87 min) compared to the femoral group (19.41 min; p<0.000). Complication rates were similar between the two groups. The incidence of bleeding was 2.13% and 2.22% in radial and femoral group, respectively (p>0.05). CONCLUSION: The present study demonstrates that radial vascular access is increasingly being utilized in our institution. Transradial approach can be safely offered to patients with its high success rate and low conversion to femoral route. Complications of coronary procedures in the femoral and radial group were comparable in this study.