Safety and efficacy of brachial approach for coronary angiography and percutaneous coronary intervention

Area of Science:

• Cardiology
• Interventional Cardiology
• Vascular Access

Background:

• Percutaneous coronary interventions (PCI) commonly use radial artery access due to low complication rates.
• Radial artery access may not be feasible due to anatomical variations or spasm.
• Femoral artery access is an alternative, but brachial artery access remains controversial.

Purpose of the Study:

• To evaluate the effectiveness and safety of brachial artery access compared to femoral artery access in patients undergoing PCI.
• To determine if brachial artery access is a viable alternative when radial access is not possible.

Main Methods:

• A comparative study of 300 patients undergoing elective coronary angiography and angioplasty with failed radial access.
• Patients were divided into two groups: 150 with brachial access and 150 with femoral access.
• Key metrics including access time, procedure time, fluoroscopy time, contrast volume, and complication rates were recorded and analyzed.

Main Results:

• Brachial access demonstrated significantly shorter access times (P=0.05) and hospital stays (P<0.001) compared to femoral access.
• The brachial group experienced significantly fewer major (P=0.04) and minor complications (P=0.05), particularly hematomas.
• No significant differences were observed in procedure time, fluoroscopy time, or contrast volume between the two groups.

Conclusions:

• Brachial artery access is a safe and effective alternative for coronary interventions when radial access is not feasible.
• It is non-inferior to the femoral artery approach and offers advantages in terms of access time and complication rates.