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Coronary Angiography Safety between Transradial and Transfemoral Access
Santosh Kumar Sinha1, Vikas Mishra1, Nasar Afdaali1
1Department of Cardiology, LPS Institute of Cardiology, G.S.V.M. Medical College, Kanpur, Uttar Pradesh 208002, India.
Insights
The transradial approach for coronary angiography is as safe and feasible as the transfemoral approach, with significantly fewer vascular complications. This method offers comparable procedure times and radiation exposure, making it a viable alternative.
Area of Science:
- Cardiology
- Interventional Cardiology
- Vascular Access
Background:
- Coronary catheterization is a common procedure.
- Transradial approach is an alternative to transfemoral approach.
- Concerns exist regarding transradial approach's procedure time and radiation exposure.
Purpose of the Study:
- To evaluate the safety and feasibility of the transradial approach compared to the transfemoral approach.
- To compare procedural variables including time, contrast volume, and radiation dose.
- To assess vascular access site complications.
Main Methods:
- 1,997 patients undergoing coronary catheterization were randomized to transradial or transfemoral approach.
- Data collected included procedure time, fluoroscopy time, contrast volume, and radiation dose.
- Vascular access site complications and serum creatinine levels were monitored.
Main Results:
- Successful catheterization rates were high for both approaches (97.1% transradial vs. 99.7% transfemoral).
- No significant differences were observed in fluoroscopy time, procedure time, contrast volume, or radiation dose.
- Vascular access site complications were significantly lower in the transradial group (3.9% vs. 7.6%).
Conclusions:
- Transradial access is a safe and feasible option for coronary angiography.
- It is associated with a lower rate of local vascular complications compared to the transfemoral approach.
- Procedural efficiency and radiation exposure are comparable between the two methods.
Abstract:
Background and Aim. The aim of study was to evaluate safety, feasibility, and procedural variables of transradial approach compared with transfemoral approach in a standard population of patients undergoing coronary catheterization as one of the major criticisms of the transradial approach is that it takes longer overall procedure and fluoroscopy time, thereby causing more radiation exposure. Method. Between January 2015 and December 2015, a total of 1,997 patients in LPS Institute of Cardiology, GSVM Medical College, Kanpur, UP, India, undergoing coronary catheterization were randomly assigned to the transradial or transfemoral approach. Result. Successful catheterization was achieved in 1045 of 1076 patients (97.1%) in the transradial group and in 918 of 921 patients (99.7%) in the transfemoral group (p = 0.001). Comparing the transradial and transfemoral approaches, fluoroscopy time (2.46 ± 1.22 versus 2.83 ± 1.31 min; p = 0.32), procedure time (8.89 ± 2.72 versus 9.33 ± 2.82 min; p = 0.56), contrast volume (67.52 ± 22.54 versus 71.63 ± 25.41 mL; p = 0.32), radiation dose as dose area product (24.2 ± 4.21 versus 22.3 ± 3.46 Gycm2; p = 0.43), and postprocedural rise of serum creatinine (6 ± 4.5% versus 8 ± 2.6%; p = 0.41) were not significantly different while vascular access site complications were significantly lower in transradial group than transfemoral group (3.9% versus 7.6%; p = 0.04). Conclusion. The present study shows that transradial access for coronary angiography is safe among patients compared to transfemoral access with lower rate of local vascular complications.
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