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[Percutaneous coronary angioplasty via the radial artery. Feasibility and safety]
R Choussat1, A J Black, B Cassagneau
1Unité de cardiologie interventionnelle, clinique Pasteur, Toulouse.
Insights
Percutaneous coronary angioplasty via the radial artery approach is feasible and safe. This method demonstrated a low rate of cardiac and vascular complications in a large patient cohort.
Area of Science:
- Cardiology
- Interventional Cardiology
- Vascular Surgery
Context:
- Percutaneous coronary angioplasty (PCA) is a common procedure for treating coronary artery disease.
- The radial artery approach has emerged as an alternative to the traditional femoral artery approach.
- Assessing the feasibility and safety of the radial artery approach is crucial for clinical practice.
Purpose:
- To evaluate the feasibility and safety of percutaneous coronary angioplasty using the radial artery approach.
- To determine the rates of cardiac and vascular complications associated with this technique.
Summary:
- A total of 5,354 percutaneous coronary angioplasties were performed using the radial artery approach between February 1994 and December 1998.
- The radial artery approach demonstrated high technical success (98% cannulation, 99% angiographic success) and was increasingly adopted, reaching 78% of cases by 1998.
- Serious cardiac complications occurred in 1.5% of patients, with a mortality rate of 0.3%. Vascular complications were also low, including 0.5% hematomas at the puncture site.
Impact:
- The radial artery approach is a feasible and safe option for percutaneous coronary angioplasty.
- This approach is associated with a relatively low incidence of cardiac and vascular complications when performed by trained operators.
- Findings support the wider adoption of the radial artery approach in interventional cardiology practices.
Abstract:
The authors report the results of percutaneous coronary angioplasty using the radial approach with respect to feasibility and safety. Between February 1994 and December 1998, out of a total of 9,070 coronary angioplasties performed in our Institute, the radial arterial approach was chosen in 5,354 cases (59%). During this period, the proportion of procedures performed via the radial artery progressively increased to 78% of cases in 1998. Cannulation of the radial artery was successful in 5,244 cases (98%). Rotatory atherectomy was used in 96 cases (2%), the excimer laser in 38 cases (1%) and stenting was performed in 3,350 cases (64%). Angiographic success was obtained in 5,224 patients (99%). Serious cardiac complications occurred in 82 patients (1.5%), including 17 deaths (0.3%), 22 Q wave myocardial infarctions (0.4%), 28 non-Q wave infarcts (0.5%), 5 coronary bypass procedures (0.1%) and 10 sub-acute occlusions (0.2%). The vascular complications included 1 death due to an ischaemic cerebrovascular accident, 25 haematomas at the puncture site (0.5%) and 3 surgical arterial repairs. The radial pulse disappeared after the procedure in 4% of cases, all asymptomatic. Angioplasty by the radial artery in the hands of trained operators is feasible and associated with a relatively low rate of cardiac and vascular complications.