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The radial approach has been increasingly used as an alternative to femoral access as it improves patients' comfort and permits earlier ambulation and discharge. Our aim was to assess the feasibility, and safety of transradial approach (TRA) versus transfemoral approach (TFA) for diagnostic coronary angiography, during early phase of the learning curve.
This is a prospective single-centre comparative study carried out at the catheterization laboratory at Suez Canal University hospital. We enrolled 203 consecutive patients referred to our centre for diagnostic coronary angiography. Patients were divided into TRA or TFA groups. We compared the two groups regarding access / procedure success and time, fluoroscopy time, contrast volume, length of hospital stay and complications. All studies were performed by 3 angiographers with different level of experiences.
There was no significant difference in access success between the two groups. However, TFA was associated with significantly higher procedure success than TRA (96.7% versus 76.7% respectively, p-Value = 0.002). TRA was more time consuming than transfemoral one (23.2 ± 8.4 min. versus 19.4 ± 5.9 min. respectively, p-value = 0.007). Compared with TFA group, TRA had a significantly longer X-ray exposure time (8.9 ± 2.27 min. versus 7.1 ± 1.6 min. respectively, p-value = 0.002) and associated with larger amount of contrast (148.04 ± 23.1 ml. versus 132.4 ± 22.7 ml. respectively, p-value = 0.001). Total length of hospital stay was significantly shorter in the TRA group than in TFA (5.1 ± 1.2 hour Vs 8.9 ± 1.5 hour respectively.
p = 0.0001). TFA had higher access site haematoma while arterial spasm was encountered only with TRA.
Compared with transfemoral approach, transradial approach for coronary angiography is a safe and feasible alternative that is associated with lower local vascular complication rates and shorter hospital stay. However, transradial approach is associated with some technical difficulties at the early phase of the learning curve that may improve with accumulating experience.
- 2013 American College of Cardiology Foundation