Abstract
BackgroundPCI has been done traditionally through transfemoral route. But now transradial and transbrachial routes are also coming up in practice. We compared transradial versus transfemoral routes for ease of operability, time for procedure, complications, and failure rates through a prospective study.MethodsFour hundred Patients admitted in department of cardiology for percutaneous interventions were enrolled in the study. 200 patients were assigned to each group randomly. A single team did all the procedures. Pre procedure, intra procedure and post procedure data of all the patients was collected, tabulated and analysed properly.ResultsAccess time (6.0 ± 1vs 4.2 ± 0.7; P =0.001); Fluoroscopy time and overall procedure time (29 ± 11.3 Vs. 27.3 ± 12.4 min) were more with trans radial than transfemoral route, respectively. The most common post procedure complication, ecchymosis was seen in 20.5% in transfemoral group compared to 12.5% in transradial group (P 0.031). Thrombophelibites (17.5 VS 8%, P0.004); Hematoma (14.5 Vs 0%, P 0.005); post procedure access bleed (7 VS 3%, P 0.039) were seen in transfemoral than transradial group, respectively. Failure rates were almost similar. None of our patients had post procedure myocardial infarction, stroke, acute renal failure and infections.ConclusionTransradial approach of PCI is better than transfemoral route with respect to complications like bleeding, haematoma formation, thrombophelebites and ecchymosis is concerned. However access and fluoroscopic time is more with the former. We recommend the transradial route for PCI.Trial registrationTrial is retrospectively registered in ClinicalTrials.gov with the Identifier: NCT02983721, Date of registration is December 2, 2016.
Highlights
Percutaneous coronary intervention (PCI) has been done traditionally through transfemoral route
A total of 400 patients were enrolled in this prospective comparative study over a period of 2 years and 2 months from September 2013 to November 2015 (200 patients in transradial approach group and 200 in transfemoral approach group)
LAD + RCA disease was common in transfemoral group and left circumflex (LCX) + RCA disease was commonly picked in transradial group
Summary
PCI has been done traditionally through transfemoral route. Transradial and transbrachial routes are coming up in practice. We compared transradial versus transfemoral routes for ease of operability, time for procedure, complications, and failure rates through a prospective study. Coronary artery disease has had high morbidity and mortality for a long time. The common femoral artery has long been the access site for doing coronary angiography and angioplasty. Femoral artery has been the preferred site of access because of the larger size and the larger diagnostic and angioplasty guiding catheters being used lately. Vascular access site bleeding is one of the most feared complications with the use of anticoagulants and platelet glycoprotein inhibitors [2]. Percutaneous coronary intervention (PCI) can be performed by the following three routes: femoral, brachial or radial arteries.
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