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Clinical Study of Radial Versus Femoral Artery Approach for Percutaneous Transluminal Coronary Angioplasty

Somashekhara G. Assistant Professor, Department of Cardiology, Vijayanagara Institute of Medical Sciences, Ballari, Karnataka 583104, India. , Somashekhara G.

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Journal of Cardiovascular Medicine and Surgery 3(2):p 184-192, Jul-Dec 2017. | DOI: http://dx.doi.org/10.21088/jcms.2454.7123.3217.17

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Abstract

Introduction: 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 January 2013 and March 2014, a total of 200 patients undergoing Percutaneous Transluminal Coronary Angioplasty were selected with 100 patients each intransradial or transfemoral arteryapproach. Patients with an abnormal Allen’s test, simultaneous right heart catheterization, chronic renal insufficiency, or known difficulties with the radial or femoral access were excluded. Results: Mean age of presentation in radial arm was 57years and in femoral arm was 54.8years. 90% patients were male and 10% female in radial arm (male; female ratio 9:1) and 82% male and 18% female in femoral arm (male; female ratio 8.2:1.8). Clinical presentation in both groups were similar. The number of patients presenting with ACS were 66% in radial arm and 69% in femoral arm. 57% patients in radial arm and 52% in femoral arm were either overweight or obese. Conventional risk factor profile was similar in both groups. All patients of femoral group and 99% patients of radial group underwent successful procedure and one patient in radial group had cross over to femoral access. More number of stents were used in femoral arm than radial arm (131 vs116 p<0.3) but the difference was statistically insignificant. Conclusion: Radial approach to percutaneous transluminal coronary angioplasty is a safe, feasible and effective technique and yields clinical results comparable to femoral approach. Radial approach virtually abolishes access site bleeding complications. However technical challenges may impose crossover to another approach.

 

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DOI: http://dx.doi.org/10.21088/jcms.2454.7123.3217.17

Keywords

Radial Approach; Femoral Approach; Percutaneous Transluminal Coronary Angioplasty. 

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