Abstract
Background and Aim. The aim of study was to evaluate safety, feasibility, and procedural variables of transradial approach compared with transfemoral approach in a standard population of patients undergoing coronary catheterization as one of the major criticisms of the transradial approach is that it takes longer overall procedure and fluoroscopy time, thereby causing more radiation exposure. Method. Between January 2015 and December 2015, a total of 1,997 patients in LPS Institute of Cardiology, GSVM Medical College, Kanpur, UP, India, undergoing coronary catheterization were randomly assigned to the transradial or transfemoral approach. Result. Successful catheterization was achieved in 1045 of 1076 patients (97.1%) in the transradial group and in 918 of 921 patients (99.7%) in the transfemoral group (p = 0.001). Comparing the transradial and transfemoral approaches, fluoroscopy time (2.46 ± 1.22 versus 2.83 ± 1.31 min; p = 0.32), procedure time (8.89 ± 2.72 versus 9.33 ± 2.82 min; p = 0.56), contrast volume (67.52 ± 22.54 versus 71.63 ± 25.41 mL; p = 0.32), radiation dose as dose area product (24.2 ± 4.21 versus 22.3 ± 3.46 Gycm2; p = 0.43), and postprocedural rise of serum creatinine (6 ± 4.5% versus 8 ± 2.6%; p = 0.41) were not significantly different while vascular access site complications were significantly lower in transradial group than transfemoral group (3.9% versus 7.6%; p = 0.04). Conclusion. The present study shows that transradial access for coronary angiography is safe among patients compared to transfemoral access with lower rate of local vascular complications.
Highlights
The aim of study was to evaluate safety, feasibility, and procedural variables of transradial approach compared with transfemoral approach in a standard population of patients undergoing coronary catheterization as one of the major criticisms of the transradial approach is that it takes longer overall procedure and fluoroscopy time, thereby causing more radiation exposure
Between January 2015 and December 2015, a total of 1,997 patients in LPS Institute of Cardiology, GSVM Medical College, A Kanpur, UP, India, undergoing coronary catheterization were randomly assigned to the transradial or transfemoral approach
The present study shows that transradial access for coronary angiography is safe among patients compared to transfemoral access with lower rate of local vascular complications
Summary
Following the first report of radial coronary angiographyE by Campeau in 1989 and radial percutaneous coronary intervention (PCI) by Kiemeneij et al in 1992, there is an increase in use of transradial access (TRA) because of lowerRaccess site bleeding, patient preference and satisfaction, early overall procedure and fluoroscopy time, which means more radiation exposure to cath lab personnel as they will stand close to patient where rates of radiation scattered will be higher [5] So, the aim of this study was to evaluate the safety of transradial approach versus transfemoral approach in routine coronary angiography practice in terms of crossover rate from one to the other, contrast amount, overall procedure ambulation, reduced morbidity, and lower procedural cost time, fluoroscopy time, and complications.over transfemoral approach around the world [1,2,3]. It was prospective, randomized, single-centre approach have been performed through right radial route study conducted in the Department of Cardiology, LPS because of familiarity in performing the study from the Institute of Cardiology, GSVM Medical College, Kanpur, U.P, patient’s right side as commonly used in femoral approach India where all cases of diagnostic coronary angiography though it can be done from left radial route as well. It is (CAG) of 1997 consecutive patients for various reasons over a not totally immune from criticism and complications.
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