Safety and feasibility of transradial coronary angioplasty in elderly patients.
BACKGROUND
The aim of this study was to assess the safety, feasibility and efficacy of transradial coronary angioplasty in elderly (> or = 70 years) vs younger patients (< 70 years).


METHODS
We studied 1125 consecutive patients submitted to transradial coronary angioplasty by a single operator. An angiography of the arteries of the upper limbs was performed before and after the procedure. The presence of the radial pulse was assessed at 1 month of follow-up.


RESULTS
At angiography, elderly patients (n = 323) were found to have a higher incidence of radial and brachiocephalic trunk anatomical tortuosity compared to younger subjects (35.3 vs 17.3%, p < 0.05; 10.5 vs 5.3%, p < 0.05, respectively). Radial access was successful in 98.8% of elderly and in 99% of younger patients (p = NS). The procedural success by radial access did not significantly differ between the two groups (97.5 vs 98.7%; p = NS). The cannulation time (from skin anesthesia to arterial cannulation) and the total procedure time (from patient arrival at the catheterization room to the completion of the procedure) were not significantly different between the two groups (1.5 +/- 0.8 vs 1.6 +/- 0.4 min, p = NS; 57 +/- 23 vs 56 +/- 12 min, p = NS, respectively). There were no access site bleeding complications in younger and only one (0.4%) such a complication in elderly patients. In all patients, there was no case of forearm ischemia and the incidence of asymptomatic loss of the radial pulse during the 30-day follow-up period was not different between the two groups (1.5 vs 1.4%, p = NS).


CONCLUSIONS
Performed by experienced operators, transradial access constitutes a safe and feasible approach for coronary angioplasty in elderly patients. The results are similar to those observed in younger patients.
Valsecchi
Orazio
O
Interventional Catheterization Laboratory. Cardiovascular Department, Ospedali Riuniti, Bergamo, Italy. ovalsec@tin.it
Musumeci
Giuseppe
G
Vassileva
Angelina
A
Tespili
Maurizio
M
Guagliumi
Giulio
G
Mihalcsik
Laurian
L
Rossini
Roberta
R
Gavazzi
Antonello
A
Ferrazzi
Paolo
P
D000367:Age Factors; D000368:Aged; D000369:Aged, 80 and over; D015906:Angioplasty, Balloon, Coronary / Q000379:methods*; D003324:Coronary Artery Disease / Q000000981:diagnostic imaging / Q000628:therapy*; D005240:Feasibility Studies; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D008297:Male; D008875:Middle Aged; D011446:Prospective Studies; D017534:Radial Artery / Q000000981:diagnostic imaging; D011859:Radiography; D015607:Stents; D016896:Treatment Outcome