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Updated: Feb 5, 2026
Implantation of Human-Sized Coronary Stents into Rat Abdominal Aorta Using a Trans-Femoral Access
Published on: November 19, 2020
Retrospective analysis of coronary interventions in a single centre and comparison of specific differences between
Jakub Rychlik1, Ivan Hornacek2, Miloslav Tejc2
1a Department of Cardiology, Jihlava Hospital , Jihlava , Czech Republic.
Insights
Radial access during coronary interventions reduces pseudoaneurysms but may increase radiation dose and fluoroscopy time, especially in patients with coronary artery bypass grafts. Femoral access offers lower radiation and shorter times for these patients.
Area of Science:
- Cardiology
- Interventional Cardiology
- Radiology
Background:
- Current guidelines often favor radial access over femoral access for coronary interventions due to safety concerns, particularly in acute coronary syndromes.
- However, some studies question trial designs and antithrombotic management, and the impact of access site on radiation dose and fluoroscopy time remains unclear.
- Body mass index (BMI) significantly influences radiation dose, with a 23% increase for every five-point rise in BMI.
Purpose of the Study:
- To analyze the impact of radial versus femoral access during coronary interventions on radiation dose, fluoroscopy time, and pseudoaneurysm incidence.
- To compare outcomes between radial and femoral access in a large patient cohort undergoing coronary angiography.
Main Methods:
- Retrospective analysis of 4522 patients undergoing coronary angiography between 2012 and 2016.
- Comparison of radiation dose (Gy/cm² or mSv), mean effective dose, average fluoroscopy time (minutes), and pseudoaneurysm incidence based on access site (radial vs. femoral).
Main Results:
- Femoral access was associated with lower fluoroscopy time across all subgroups (p < .001).
- Femoral access decreased radiation dose by 26% in patients with coronary artery bypass grafts (CABGs) (p = .044).
- Radial access demonstrated a 16-fold lower incidence of post-catheterization pseudoaneurysms compared to femoral access (p < .001).
Conclusions:
- Femoral access resulted in lower radiation dose and fluoroscopy time for patients with CABGs.
- Radial access significantly reduced the occurrence of periprocedural pseudoaneurysms.
- Radial access is recommended for patients at high risk of pseudoaneurysm development, while femoral access may be preferable for those at high risk of contrast-induced nephropathy.
Abstract:
Objectives: The aim of this study was to analyse the consequence of radial or femoral access during coronary interventions to radiation dose, fluorography time and a number of pseudoaneurysms following each type of intervention. Background: According to the results of many recent studies (RIVAL, RIFLE-STEACS, STEMI RADIAL), current guidelines favour radial over femoral access during coronary intervention for safety, especially in cases of acute coronary syndromes. However, several papers have referred to problems in the design of these studies and the management of antithrombotic therapy. The influence of access site on radiation dose and fluorography time is also still unclear. Methods: We retrospectively analysed 4522 patients who underwent coronary angiography in 2012 and 2016 in a single centre in the Czech Republic. We compared the access site with the average radiation dose and mean effective dose that each patient received in Gy/cm2 or mSv, respectively. We also compared average fluorography time in minutes and the incidence of pseudoaneurysms. Results: The radiation dose was a body mass index (BMI)-dependent parameter since each five points of body mass index increased radiation dose approximately by 23%. Use of femoral access resulted in lower fluorography time in all subgroups (p < .001) and decreased radiation dose in patients with coronary artery bypass grafts (CABGs) by 26% (p = .044). On the other hand, there has been 16 times lower frequency (p < .001) of post-catheterisation pseudoaneurysms after radial access than after femoral access. Conclusions: Both the radiation dose and fluorography time were lower after femoral access compared to radial access in patients with CABGs. On the other hand, radial access led to significantly fewer periprocedural pseudoaneurysms. Radial access therefore should be considered as the preferred access site during coronary intervention in patients with a high risk of pseudoaneurysm development, and femoral access should be considered for patients with a high risk of contrast-induced nephropathy.
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