COMPARISON OF TRANSRADIAL VERSUS TRANSFEMORAL ACCESS FOR PERCUTANEOUS CORONARY INTERVENTION IN A TERTIARY CARDIAC CARE FACILITY

Abstract

Objective: To compare the transfemoral and transradial access in term of safety and efficacy in patients undergoing percutaneous coronary interventions.

Study Design: Observational Study.

Place and Duration of Study: Rawalpindi Institute of Cardiology, Rawalpindi Pakistan, from Jan to Nov 2019.

Methodology: Patients undergoing percutaneous coronary intervention fulfilling the criteria for both transradial and transfemoral accesses were included in the study. Clinical data were obtained from patient’s record while procedural and outcome data were obtained by observing the procedure and patients.

Results: Overall 584 patients were included. 461 patients were in radial group while 123 were in femoral group. Clinical and angiographic characteristics were similar between two groups of patients. Procedure failure was statistically similar between two groups; 1.6 vs. 4.3; p=0.16 for femoral and radial group respectively. Mean access time, procedural and fluoroscopy time was longer in radial group compared to femoral group; 2.7 ± 0.67 min vs. 11.0 ± 7.9, p=0.001, 68.0 ± 15.9 min vs. 76.1 ± 12.7 min, p=0.001, 24.7 ± 6.4 min vs. 28.8 ± 5.4 min, p=0.001 respectively. Mean amount of contrast used was higher in radial group
compared to femoral group; 237.1 ± 4.7 ml vs. 248.4 ± 9.1ml, p=0.003. Access site complications were significantly higher in the femoral group as compared to radial group; 6(4.9) Vs 7(1.5), p=0.02. Non access site complications were similar between two groups; 2(1.6) vs. 11(2.4), p=0.61 for femoral and radial groups respectively.

Conclusion: In patients treated with percutaneous coronary intervention Transradial routeis associated with a reduced number of in comparison to Transfemoral route. It is also linked with lesser procedural related morbidity but with longer procedure and fluoroscopy time.