Emergency Percutaneous Coronary Intervention Through the Left Radial Artery is Associated with Less Vascular Complications than Emergency Percutaneous Coronary Intervention Through the Femoral Artery

Guoqing Qi,Qi Sun,Yue Xia,Liye Wei

doi:10.6061/clinics/2017(01)01

Abstract

OBJECTIVE:To compare the advantages and disadvantages of emergency percutaneous coronary intervention through the left radial artery with those of emergency percutaneous coronary intervention through the femoral artery.METHODS:A total of 206 patients with acute myocardial infarction who required emergency percutaneous coronary intervention and were admitted to our hospital between January 2011 and August 2013 were divided into the following two groups: a group that underwent percutaneous coronary intervention through the left radial artery and a group that underwent percutaneous coronary intervention through the femoral artery. The times required for angiographic catheter and guiding catheter placement, the success rate of the procedure and the incidence of vascular complications in the two groups were observed.RESULTS:There was no significant difference in catheter placement time or the ultimate success rate of the procedure between the two groups. However, the left radial artery group showed a significantly lower incidence of vascular complications than the femoral artery group (p<0.05).CONCLUSION:Emergency percutaneous coronary intervention through the left radial artery is associated with less vascular complications than emergency percutaneous coronary intervention through the femoral artery and is thus potentially advantageous for patients.

Highlights

Percutaneous coronary intervention (PCI) through the right radial artery has become the first choice for the vast majority of physicians performing the procedure because it is more acceptable to patients, significantly reduces vascular complications, and facilitates faster recovery, among other advantages, compared with PCI through the femoral artery
There has been a gradual increase in the number of cases in which PCI was performed through the radial artery route, a trend paralleled by an increase in the number of cases in which interventional and direct PCI were performed for STEMI
According to the results of a study performed by Bertrand in 2010, 89.4% of the transradial PCIs performed worldwide were performed through right radial artery, and only 10.6% were performed through left radial artery [4]

Summary

Introduction

Percutaneous coronary intervention (PCI) through the right radial artery has become the first choice for the vast majority of physicians performing the procedure because it is more acceptable to patients, significantly reduces vascular complications, and facilitates faster recovery, among other advantages, compared with PCI through the femoral artery. The complicated anatomic relationship between the right radial artery and aorta (greater intersection angles, more blood vessel variations) may result in inconveniences, such as long X-ray exposure times, time-consuming catheter. To save time when performing an emergency PCI, a considerable proportion of physicians still choose to utilize the classic femoral artery route. To avoid the disadvantages of both the right radial artery and the femoral artery routes, we chose to perform emergency PCI via a left femoral artery route and compared this route with the femoral artery route

Methods

Results

Conclusion