Coronary angiography safety between radial and femoral access

Abstract

One of the major criticisms of the radial approach is that it takes longer overall procedure and fluoroscopy time, which means not only more staff will be exposed during the procedures, but they will also stand close to the patient where rates of radiation scattered by the patient are higher. The aim of this study was to evaluate the safety of the radial versus femoral artery approach in our institution’s routine coronary angiography practice. All cases of diagnostic coronary angiography (CA) over a 23 month period at a tertiary care hospital were reviewed for this analysis. Procedure duration was calculated as a total in laboratory catheter time. Contrast volume and fluoroscopy time were recorded, as it is correlated to catheter manipulation. Eight hundred patients who underwent a diagnostic CA were included in this study. The radial approach was used in 586 patients (73.25%) and the femoral approach in 214 patients (26.75%). Comparing the radial and femoral approaches, fluoroscopy and procedure times were not significantly different (3.43 ± 1.19 vs 3.86 ± 1.49 min, P = 0.215 and 31.87 ± 9.61 vs 33.24 ± 10.33 min, P = 0.170, respectively). While contrast utilization during the procedure was significantly lower in the radial than the femoral approach (67.63 ± 25.49 vs 81.53 ± 24.80 mL respectively, P = 0.03). Transradial coronary angiography can be safely performed for the patient and the professional staff members as the transfemoral approach.