Safety, Efficacy, Feasibility of Trans Radial Approach Compared with Trans Femoral Approach in Patients Undergoing Coronary Catheterization

Abstract

Background: Percutaneous Coronary Intervention has been done traditionally through Trans femoral route. Trans Radial route is coming up in the practice. We compared Trans Radial with Trans femoral accesses for ease of operability, time of procedure, complications, and failure rates through a cross sectional study. Objectives: To evaluate the safety, efficacy, feasibility and procedural variables in Trans radial approach compared with the Trans femoral Approach in patients undergoing coronary catheterization. Methods: A total of 180 patients with both chronic and acute coronary syndromes were enrolled in this study, 140cases with Radial 28 of whom were crossed to Femoral access(hence 112 Radials with 108 Right Radial and 4 Left Radial)and 68 cases with Femoral access. Results: Procedural time between Trans Radial and Trans femoral accesses were similar (17.39±10.33 vs19.68±16.62 minutes p 0.36) respectively while among Femoral crossover group was higher (33.50±20.30 minutes p0.01). Fluoroscopy time was (5.51±4.70 in Trans Radial Vs. 7.18 ±7.65 minutes in Trans femoral p 0.07) were similar in both groups. Post procedure access site complications seen in (9% in Trans Radial compared to 7.35% in Trans femoral P 0.048), Access site Hematoma being the most common one (6.25% in Trans Radial vs 4.4% in Trans femoral), Non-flow limiting dissections occurred in (0.89% in Trans Radial VS 1.4% Trans femoral), Radial artery perforation occurred in 1.78%, 1.4% of patients in Femoral group had Femoral artery perforation and had major bleeding. Conclusion: The overall local complications were lower in Trans femoral access, except for major bleeding which is still a big concern. Both vascular Access techniques should not be considered opposite or mutually exclusive, but rather provide the Interventionist a wide spectrum of the therapeutic options.