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Effect of transradial access on quality of life and cost of cardiac catheterization: A randomized comparison
C J Cooper1, R A El-Shiekh, D J Cohen
1Medical College of Ohio, Cardiology Division, Toledo, Ohio 43699-0008, USA. ccooper@mco.edu
Insights
Transradial access for cardiac catheterization improves patient quality of life and reduces hospital costs. Patients strongly prefer this minimally invasive approach over traditional transfemoral access.
Area of Science:
- Cardiology
- Vascular Access Techniques
Background:
- Transradial access is an emerging alternative for diagnostic cardiac catheterization.
- Its impact on patient quality of life, preferences, and healthcare costs remains under investigation.
Purpose of the Study:
- To compare transradial access with transfemoral access for diagnostic cardiac catheterization.
- To evaluate the effects on quality of life, patient preference, and procedural costs.
Main Methods:
- A randomized single-center trial involving 200 patients (99 transfemoral, 101 transradial).
- Quality of life assessed using SF-36 and visual analog scales.
- Complications, patient preference, and costs were prospectively measured.
Main Results:
- Transradial catheterization significantly reduced length of stay (3.6 vs 10.4 hours).
- Improved quality of life metrics (bodily pain, back pain, walking ability, role limitations) were observed in the transradial group.
- Patients showed a strong preference for transradial access (P <.0001) and associated hospital costs were reduced ($2010 vs $2299).
Conclusions:
- Transradial access enhances post-procedure quality of life for patients undergoing diagnostic cardiac catheterization.
- This approach is strongly preferred by patients and leads to significant reductions in hospital costs.
Background:
Transradial access is a recently developed alternative for diagnostic cardiac catheterization. Its effects on quality of life after the procedure, patient preference, and cost are unknown.
Methods And Results:
We performed a randomized single-center trial in which 99 patients underwent transfemoral and 101 underwent transradial diagnostic cardiac catheterization. Quality of life was measured with the SF-36 and visual analog scales at baseline, 1 day, and 1 week. Patients were examined at 1 day and at 1 week after for complications. Costs were measured prospectively. One patient in the femoral group and 2 in the radial group crossed over to the alternative access site. There were no major access site complications. One patient in the transfemoral group had a minor stroke. Transradial catheterization significantly reduced median length of stay (3.6 vs 10.4 hours, P <.0001). Over the first day after the procedure, measures of bodily pain, back pain, and walking ability favored the transradial group (P <.05 for all comparisons). Over the week after the procedure, changes in role limitations caused by physical health, bodily pain, and back pain favored the transradial group (P <.05 for all comparisons). There was a strong patient preference for transradial catheterization as well (P <. 0001). Transradial catheterization led to significant reductions in bed, pharmacy, and total hospital costs ($2010 vs $2299, P <.0001).
Conclusions:
Among patients undergoing diagnostic cardiac catheterization, transradial access leads to improved quality of life after the procedure, is strongly preferred by patients, and reduces hospital costs.
Related Concept Videos
01:28Cardiac Catheterization I: Pre-Procedure Overview
01:24Cardiac Catheterization III: Left Heart Catheterization
01:21Cardiac Catheterization II: Right Heart Catheterization
01:26Cardiac Catheterization IV: Nursing Management
01:11Assessment of radial pulse
The radial pulse, located at the wrist, is often the preferred site for assessing peripheral pulse because of its accessibility and dependability. The process of determining the radial pulse involves several steps: