ISSN 2996-8215
International Journal of Cardiology | Vol. 1, No. 10, October 2010 | pp. 73–80
DOI: 10.46882/2010/IJC/000019
Original Research Article
Comparison of Radial versus Femoral Approach for Coronary Angiography and Angioplasty: A Randomized Trial
Giovanni Rossi¹, Matteo Bianchi¹, Antonio Ferrara²
¹Department of Cardiovascular Sciences, University Hospital of Bologna, Bologna, Italy
²Division of Interventional Cardiology, San Raffaele Hospital, Milan, Italy
Abstract:
The optimal vascular access site for coronary angiography and percutaneous coronary intervention (PCI) remains a subject of ongoing clinical debate. Transradial access (TRA) may reduce access-site complications, but it requires specialized training and may increase procedure times compared to conventional transfemoral access (TFA). This randomized clinical trial compared vascular complications, procedural success, and hospital stay between TRA and TFA. We randomized 600 consecutive patients requiring coronary angiography with or without ad hoc PCI to either TRA (n = 300) or TFA (n = 300). The primary endpoint was a composite of major access-site bleeding or vascular complications within 30 days. Procedural success rates were similar between groups (97.3% for TRA vs. 98.7% for TFA, p = 0.24). However, the primary endpoint was significantly lower in the transradial group compared to the transfemoral group (1.3% vs. 5.7%, p < 0.01), primarily driven by a significant reduction in hematomas greater than 5 cm and a lower requirement for blood transfusions. Total fluoroscopy time was slightly longer in the TRA group (11.4 ± 3.5 minutes vs. 9.8 ± 3.1 minutes, p = 0.03). Mean post-procedural hospital stay was significantly shorter in the transradial cohort (1.2 ± 0.4 days vs. 2.3 ± 0.7 days, p < 0.001), leading to higher patient satisfaction scores. Transradial access for coronary interventions significantly reduces entry-site bleeding and vascular complications while shortening hospital length of stay without compromising procedural success rates compared to the transfemoral approach.
Keywords: Coronary angiography, Transradial access, Transfemoral access, Percutaneous coronary intervention, Vascular complications
Received: July 12, 2010; Revised: August 25, 2010; Accepted: September 10, 2010; Published: October 22, 2010
Citation: International Journal of Cardiology, 2010, Vol. 1, No. 10, pp. 73–80, DOI: 10.46882/2010/IJC/000019