[Transradial approach to coronary angiography and angioplasty: initial experience and learning curve].
BACKGROUND
The transradial approach has emerged as an attractive alternative to the femoral approach for coronary angiography and interventions. We describe our experience with the transradial approach and analyze the influence of the learning curve.


METHODS
The transradial approach was attempted in patients with a good radial pulse and normal Allen test. When feasible and clinically indicated, we attempted ad hoc intervention. We divided the study population into two groups: Group A (the first 200 cases) and B (all other patients). We compared the radial group with a matched femoral control group.


RESULTS
We attempted the transradial approach in 526 patients (77.6% male; age 63.5 +/- 11.51), and obtained a success rate of 93.7%. We found differences between group A and B in the success rate (91.0 vs 95.4%, p = 0,04), duration of procedure [23 (16-29) vs. 19 (15-24) minutes; p < 0.001], and fluoroscopy time [6.4 (4.2-10) vs. 5.0 (3.0-7.7) minutes; p < 0,001]. At 24 h of follow-up, we found small hematomas in 9.4%, bleeding in 4.9%, and radial artery obstruction in 2.8%, with no cases of arteriovenous fistula, pseudoaneurysm, or need for vascular surgery. We attempted intervention in 169 patients with 258 lesions, achieving angiographic success in 96.1%. We found no differences in the characteristics of the lesions and patients, or in the angiographic success rate of the radial and femoral PTCA groups.


CONCLUSIONS
The transradial approach is a safe and effective alternative to femoral catheterization. There is a significant learning curve associated with the successful performance of transradial procedures.
Salgado Fernández
Jorge
J
Servicio de Cardiología, Unidad de Hemodinámica, Hospital Juan Canalejo, Coruña, Spain. jorge@canalejo.org.
Calviño Santos
Ramón
R
Vázquez Rodríguez
José M
JM
Vázquez González
Nicolás
N
Vázquez Rey
Eugenia
E
Pérez Fernández
Ruth
R
Bouzas Zubeldía
Beatriz
B
Castro Beiras
Alfonso
A
D015906:Angioplasty, Balloon, Coronary / Q000193:education / Q000379:methods*; D006328:Cardiac Catheterization / Q000379:methods; D002408:Catheters, Indwelling / Q000706:statistics & numerical data; D017023:Coronary Angiography / Q000379:methods*; D005260:Female; D005263:Femoral Artery; D006801:Humans; D007858:Learning; D008297:Male; D008875:Middle Aged; D011183:Postoperative Complications; D017534:Radial Artery