Related Experiment Video
Updated: Sep 6, 2025
Transradial Access Chemoembolization for Hepatocellular Carcinoma Patients
Published on: September 20, 2020
Safety and Feasibility of Trans Radial Percutaneous Coronary Intervention Approach in Elderly Patients with Acute
J T Imam1, M J Uddin, S Hashem
1Dr Jamil Taufiq Imam, Assistant Professor, National Institute of Cardiovascular Diseases and Hospital (NICVD&H), Sher E Bangla Nogor, Dhaka, Bangladesh;
Insights
Transradial percutaneous coronary intervention (PCI) is a safe and effective alternative to transfemoral PCI for elderly patients with acute coronary syndrome (ACS). This approach offers improved patient comfort and quality of life with reduced vascular complications and shorter hospital stays.
Area of Science:
- Cardiology
- Interventional Cardiology
- Geriatric Medicine
Background:
- Transfemoral approach is the traditional method for coronary catheterization.
- Transradial approach is gaining popularity due to potential benefits like reduced vascular complications and improved patient comfort.
- Limited data exists comparing transradial and transfemoral PCI specifically in elderly patients with acute coronary syndrome (ACS).
Purpose of the Study:
- To compare the safety and feasibility of transradial percutaneous coronary intervention (PCI) versus transfemoral PCI in elderly patients diagnosed with ACS.
- To evaluate key procedural outcomes and post-procedural complications between the two approaches.
Main Methods:
- A prospective observational study conducted at NICVD, Dhaka, involving 80 elderly ACS patients from October 2017 to September 2018.
- Patients were divided into two groups: Group I (40 patients) underwent transradial PCI, and Group II (40 patients) underwent transfemoral PCI.
- Exclusion criteria included abnormal Allen's test, history of coronary artery bypass grafting (CABG), and chronic kidney disease (CKD).
Main Results:
- Transradial PCI showed a longer mean procedural time (37.44±5.13 min) and fluoroscopy time (21.6±4.11 min) compared to transfemoral PCI (34.42±4.42 min and 17.55±2.78 min, respectively).
- Transradial PCI resulted in significantly shorter hemostasis time (7.58±1.11 min) and ambulation time (0.00±0.00 hours) compared to transfemoral PCI (15.59±3.33 min and 15.59±3.33 hours, respectively).
- Higher rates of arterial spasm were observed in the transradial group (10.0%), while the transfemoral group had significant major (10.0%) and minor bleeding (20.0%) complications. Vessel occlusion was noted in 5.0% of the transradial cases.
Conclusions:
- Transradial PCI is a safe procedure concerning both procedural and post-procedural vascular complications in elderly ACS patients.
- The transradial approach enhances patient quality of life and comfort post-procedure, potentially shortening hospital stays.
- Transradial PCI presents a viable and attractive alternative to the conventional transfemoral approach for elderly individuals undergoing PCI.
Abstract:
Coronary catheterization is usually performed using the transfemoral approach but trans-radial has been increasingly used as an alternative to transfemoral approach due to less vascular complications, earlier ambulation time and improved patient comfort. The aim of the study was to compare the safety and feasibility of trans-radial and transfemoral PCI in the elderly ACS patients. This prospective observational study was conducted in the NICVD, Dhaka from October 2017 to September 2018. Total 80 patients were categorized into two groups according to the approach of PCI. Group I consists 40 patients who underwent trans-radial PCI and Group II consists 40 patients who underwent transfemoral PCI. Patients with abnormal Allen's test, history of CABG, CKD were excluded. Patient's demographics were same in both groups. The mean procedural time in min (37.44±5.13 vs. 34.42±4.42, p=0.004) and fluoroscopy time in min (21.6±4.11 vs. 17.55±2.78, p=0.02) were more in Group I but the mean hemostasis time in min (7.58±1.11 vs. 15.59±3.33, p=0.005) and the ambulation time in hour (0.00±0.00 vs. 15.59±3.33, p=0.001) were more in Group II. Significant arterial spasm following puncture (10.0% vs. 0.0%, p=0.01) were more in Group I. Post procedural major bleeding (0.0% vs. 10.0%, p=0.004), minor bleeding (10.0% vs. 20.0%, p=0.004) were significant in Group II but vessel occlusion (5.0% vs. 0.0%, p=0.02) were significant in Group I. Transradial PCI is safe in respect of procedural and post procedural vascular complications. Transradial procedure leads to improved quality of life after the procedure and thus gives much comfort to the patient. It also shortened mean duration of hospital stay. So transradial approach is an attractive alternative to conventional transfemoral approach in the elderly.
Related Concept Videos
01:27Peripheral Artery Disease III: Interprofessional Care
01:28Cardiac Catheterization I: Pre-Procedure Overview
01:28Acute Coronary Syndrome IV: Interprofessional Care
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:
01:30Acute Coronary Syndrome III: Diagnostic Studies