A comparison of the radial and the femoral approach in vein graft PCI. A retrospective study.
BACKGROUND
Transradial PCI is a safe and effective method of percutaneous revascularization. However, there is limited data on the efficacy of the transradial approach for saphenous vein graft (SVG) PCI.


METHODS
We studied 334 patients who underwent SVG PCI between January 2000 and December 2003, and compared the radial (132 patients) and the femoral (202 patients) approach.


RESULTS
Mean EF (55.6+/-18.6% radial versus 58.1+/-16.8% femoral), lesion location (proximal, mid, distal: 22.6/50.6/26.7% versus 22.6/44.5/32.9% respectively) and lesion type (B1/B2/C: 3.4/4.1/92.5% versus 0.4/3.1/96.5%) were similar in both groups (P>0.05). Five patients had a failed radial attempt (3.8%) and were switched to the femoral approach. Mean fluoroscopy time (20.4+/-12.2 versus 18.4+/-10.2 min), procedural time (60.0+/-27.2 versus 61.6+/-24.9 min) and the use of contrast (223+/-91 versus 234+/-91 ml) IIB/IIIA inhibitors (27.2 versus 33.2%), and stenting (81.5 versus 81.3%) were similar in both groups, whereas 5 or 6 French sheaths were used more often in the radial group (83.4 versus 64.9%, P<0.01). Angiographic success (93.9 versus 92.9%), in hospital MACE (radial:5 MI (3.8%) versus femoral: 1 death (0.5%) and 7 MI (3.5%) and major vascular complications (0.7 versus 0.5%) were also similar.


CONCLUSIONS
The radial approach in SVG PCI is as fast and successful as the femoral.
Ziakas
Antonios
A
Royal Jubilee Hospital, Victoria, BC, Canada.
Klinke
Peter
P
Mildenberger
Richard
R
Fretz
Eric
E
Williams
Malcolm
M
Della Siega
Antony
A
Kinloch
David
D
Hilton
David
D
D000368:Aged; D000369:Aged, 80 and over; D015906:Angioplasty, Balloon, Coronary / Q000379:methods*; D001026:Coronary Artery Bypass / Q000009:adverse effects*; D023921:Coronary Stenosis / Q000628:therapy*; D005263:Femoral Artery; D006801:Humans; D008875:Middle Aged; D017534:Radial Artery; D012189:Retrospective Studies; D012501:Saphenous Vein / Q000637:transplantation*