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Cardiovascular outcomes of transradial versus transfemoral percutaneous coronary intervention in End-Stage renal

Yasar Sattar1, Mohammed Faisaluddin2, Talal Almas3

  • 1West Virginia University, Morgantown, WV, USA.

International Journal of Cardiology. Heart & Vasculature
|September 2, 2022
PubMed

Insights

Transradial access (TR-PCI) significantly reduces mortality, bleeding, and transfusion needs compared to transfemoral access (TF-PCI) in patients with end-stage renal disease undergoing percutaneous coronary intervention.

Area of Science:

  • Cardiology
  • Nephrology
  • Interventional Cardiology

Background:

  • Limited comparative data exists for transradial (TR) versus transfemoral (TF) access in percutaneous coronary intervention (PCI) for end-stage renal disease (ESRD) patients.
  • ESRD patients represent a vulnerable population with potentially higher risks during PCI procedures.

Purpose of the Study:

  • To compare cardiovascular outcomes between TR and TF access in ESRD patients undergoing PCI.
  • To identify potential benefits of TR access in this specific patient group.

Main Methods:

  • A systematic review and meta-analysis of online databases was conducted.
  • Included studies compared outcomes of TR-PCI versus TF-PCI in ESRD patients.
  • Key outcomes assessed included mortality, cerebrovascular accidents (CVA), myocardial infarction (MI), bleeding, transfusion, and cardiogenic shock (CS).

Main Results:

  • Six studies comprising 7,607 patients (1,288 TR-PCI, 6,319 TF-PCI) were analyzed.
  • TR-PCI was associated with significantly lower rates of mortality (OR 0.46), bleeding (OR 0.45), and transfusion (OR 0.52) compared to TF-PCI.
  • No significant differences were observed in periprocedural MI, CS, or CVA between the two access methods.

Conclusions:

  • Transradial access demonstrates a favorable safety profile in ESRD patients undergoing PCI.
  • TR-PCI is associated with reduced mortality, bleeding, and transfusion requirements compared to TF-PCI in this population.
  • These findings support the consideration of TR access for PCI in patients with end-stage renal disease.
Abstract

Keywords:
End-stage renal diseasePercutaneous Coronary interventionTransfemoralTransradial

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