top banner image  

topleft corner image     top right corner image
 


bullet

JACC Homepage JACC Imaging Homepage
Still not a subscriber to JACC Imaging or JACC Interventions?

     top nav image

     

J Am Coll Cardiol Intv, 2009; 2:1047-1054, doi:10.1016/j.jcin.2009.07.016
© 2009 by the American College of Cardiology Foundation
This Article
Right arrow Figures Only
Right arrow Full Text
Right arrow Full Text (PDF)
Right arrow Alert me when this article is cited
Right arrow Alert me if a correction is posted
Services
Right arrow Email this article to a friend
Right arrow Similar articles in this journal
Right arrow Alert me to new issues of the journal
Right arrow Download to citation manager
Citing Articles
Right arrow Citing Articles via HighWire
Google Scholar
Right arrow Articles by Brueck, M.
Right arrow Articles by Tillmanns, H.
PubMed
Right arrow Articles by Brueck, M.
Right arrow Articles by Tillmanns, H.
Related Collections
Right arrowRelated Article

Clinical Research

A Randomized Comparison of Transradial Versus Transfemoral Approach for Coronary Angiography and Angioplasty

Martin Brueck, MD*,*, Dirk Bandorski, MD*, Wilfried Kramer, MD*, Marcus Wieczorek, MD{dagger}, Reinhard Höltgen, MD{dagger}, Harald Tillmanns, MD{ddagger}

* Department of Cardiology, Clinic of Wetzlar, Wetzlar, Germany
{dagger} Department of Cardiology, Evangelisches und Johanniter Klinikum Niederrhein gGmbH, Duisburg, Germany
{ddagger} Department of Cardiology, University of Giessen, Giessen, Germany

* Reprint requests and correspondence: Dr. Martin Brueck, Department of Cardiology, Clinic of Wetzlar, Forsthausstrasse 1, 35578 Wetzlar, Germany (Email: Martin.Brueck{at}hkw.med.uni-giessen.de).

Objectives: The aim of the study was to evaluate the safety, feasibility, and procedural variables by the transradial approach compared with the transfemoral access in a standard population of patients undergoing coronary catheterization.

Background: Coronary catheterization is usually performed via the transfemoral approach. Transradial access may offer some advantages in comparison with transfemoral access especially under conditions of aggressive anticoagulation and antiplatelet treatment.

Methods: Between July 2006 and January 2008, a total of 1,024 patients undergoing coronary catheterization were randomly assigned to the transradial or transfemoral approach. Patients with an abnormal Allen's test, history of coronary artery bypass surgery, simultaneous right heart catheterization, chronic renal insufficiency, or known difficulties with the radial or femoral access were excluded.

Results: Successful catheterization was achieved in 494 of 512 patients (96.5%) in the transradial and in 511 of 512 patients (99.8%) in the transfemoral group (p < 0.0001). Median procedural duration (37.0 min, interquartile range [IQR] 19.6 to 49.1 min vs. 40.2 min, IQR 24.3 to 50.8 min; p = 0.046) and median dose area product (38.2 Gycm2, IQR 20.4 to 48.5 Gycm2 vs. 41.9 Gycm2, IQR 22.6 to 52.2 Gycm2; p = 0.034) were significantly lower in the transfemoral group compared with the transradial access group. A median amount of contrast agent was similar among both groups. Vascular access site complications were higher in the transfemoral group (3.71%) than in the transradial group (0.58%; p = 0.0008)

Conclusions: The findings of the present study show that transradial coronary angiography and angioplasty are safe, feasible, and effective with similar results to those of the transfemoral approach. However, procedural duration and radiation exposure are higher using the transradial access. In contrast to the transfemoral route, the rate of major vascular complications was negligible using the transradial approach.

Key Words: access site complications • coronary angiography • transfemoral approach • transradial approach

Abbreviations and Acronyms
  ACT = activated clotting time
  CAD = coronary artery disease
  DAP = dose area product
  IQR = interquartile range
  PCI = percutaneous coronary intervention
  UFH = unfractionated heparin


Related Article

Cardiac Catheterization on the Road Less Traveled: Navigating the Radial Versus Femoral Debate
Morton J. Kern
J. Am. Coll. Cardiol. Intv. 2009 2: 1055-1056. [Full Text] [PDF]



This article has been cited by other articles:


Home page
J Am Coll Cardiol IntvHome page
M. J. Kern
Cardiac Catheterization on the Road Less Traveled: Navigating the Radial Versus Femoral Debate
J. Am. Coll. Cardiol. Intv., November 1, 2009; 2(11): 1055 - 1056.
[Full Text] [PDF]



 
   
 
home link current link search link archive link topics link cardiology careers link