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[Transradial diagnostic and interventional cardiac catheterization in daily practice: advantages, efficacy and
Khalid Suleiman1, Alexsander Feldman, Limor Ilan-Bushari
1Heart Institute, Ha'Emek Medical Center, Afula, Israel. Suleiman_kh@clalit.org.il
Insights
Transradial cardiac catheterization significantly reduces vascular complications and hospital stay in high-risk patients compared to the transfemoral approach. This method offers a safer alternative for cardiac procedures, improving patient outcomes.
Area of Science:
- Cardiology
- Vascular Surgery
- Interventional Cardiology
Context:
- The transfemoral approach is the standard for cardiac catheterization.
- Transradial approach offers potential benefits but has a steeper learning curve.
- High-risk patients are prone to vascular complications.
Purpose:
- To compare the safety and efficacy of transradial versus transfemoral cardiac catheterization.
- To assess outcomes in patients at high risk for vascular complications.
Summary:
- A single-center study of 3084 cardiac catheterizations (28% transradial, 72% transfemoral) found the transradial group had more high-risk patients.
- Transradial access showed significantly lower vascular complications (0.03% vs. 3.1%) and shorter hospital stays (1.32 days).
- Despite longer fluoroscopy time and higher crossover rates, transradial catheterization proved safe and effective for high-risk individuals.
Impact:
- Transradial cardiac catheterization is a safe and effective alternative for reducing vascular complications in high-risk patients.
- This approach can lead to improved patient recovery and reduced healthcare resource utilization.
- Findings support wider adoption of the transradial technique in specific patient populations.
Unlabelled:
The transfemoral approach is still considered as the standard technique for cardiac catheterization. The transradial approach is associated with a lower incidence of vascular access site complications and shorter hospital stay, although it is more demanding and requires a longer learning curve.
Aims:
To assess advantages, efficacy and safety of the transradial versus transfemoral cardiac catheterization in patients with high risk to develop vascular complications.
Methods:
Single center, case series study. Catheterization data, vascular complications and rehospitalizations were collected prospectively. The site of access was determined by the operator preference, patient suitability and the risk for local bleeding.
Results:
From November 2005 through August 2007 a total of 3084 consecutive cardiac catheterization were performed: 871 (28%) transradial and 2213(72%) transfemoral. The transradial group included higher rates of patients with high risk to develop entry site vascular complications (obese, anticoagulation therapy and peripheral vascular disease) than the femoral group (p < 0.0001). Crossover to alternative access site was 4.5% in the radial versus 0.03% in the femoral group (OR 3.17, CI 95% 2.78 to 3.60, p < 0.0001). Fluoroscopy time was 2 minutes higher in the radial group (p = 0.043). Entry site vascular complications were significantly lower in the radial compared to femoral group, 0.03% versus 3.1% respectively (OR 0.1, CI 0.06 to 0.35, p < 0.0001). Hospital stay was 1.32 days shorter in the radial group (p < 0.0001). The increased number of radial catheterization was correlated significantly with decreased incidence of vascular complications (Pearson's rp = -0.927, p < 0.0001).
Conclusion:
Transradial cardiac catheterization is a safe and effective approach to reduce vascular complications in high risk patients.
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Definition and Purpose
An X-ray, or radiograph, is a non-invasive method that uses ionizing radiation to take images of internal structures. It is mainly used in cardiac imaging to examine the heart, lungs, and major blood vessels, aiming to identify abnormalities in the heart's size, shape, and position, such as heart failure, congenital defects, and vascular...