Transradial right and left heart catheterizations: a comparison to traditional femoral approach.
OBJECTIVE
This study compares the transradial versus transfemoral approach to combined right- and left-heart catheterization.


BACKGROUND
Central venous access from peripheral veins has been a historically useful technique. Although the need for right-heart catheterization has been considered an exclusion for transradial catheterization, we have combined a peripheral approach to the central venous system with radial arterial access which permits bilateral heart catheterization using a transradial approach.


METHODS
Over an 18-month period all right-heart catheterizations done in conjunction with arterial access were reviewed. Salvage procedures, mixed site access, and biopsy procedures were excluded. Radial procedures were performed using radial artery access and a forearm vein. Femoral procedures used femoral artery/vein. Demographics, procedural information, and postprocedural complications including those requiring vascular ultrasound or transfusion were recorded and used for comparison between groups.


RESULTS
Total of 175 femoral/105 radial cases done by 4 operators met criteria for comparison. Both groups had similar procedural indications and age. Procedural durations were shorter (P < .01) with radial 70 +/- 5.0 min (+/-95% CI) vs. femoral 75 +/- 5.4 min (+/-95% CI). Crossover was noted in several patients from both groups; radial procedures (n = 2) failed due to previous shoulder trauma. Femoral crossover to radial involved difficult arterial access. Complications related to access site occurred in 12 femoral and 0 radial patients.


CONCLUSIONS
Using the forearm for central venous access appears safer than using the femoral vessels. Transradial catheterizations can be done in combination with forearm venous access procedures with excellent results and enhanced patient safety.
Penn State Heart and Vascular Institute, Hershey Medical Center, Hershey, Pennsylvania 17033-0850, USA. icg1@psu.edu
Ian C
IC
Gilchrist
Carey D
CD
Moyer
Joseph A
JA
Gascho
D000368:Aged; D015906:Angioplasty, Balloon, Coronary; D006328:Cardiac Catheterization / Q000009:adverse effects / Q000379:methods*; D017023:Coronary Angiography; D005260:Female; D005263:Femoral Artery / Q000601:surgery*; D005268:Femoral Vein / Q000601:surgery*; D005542:Forearm / Q000098:blood supply*; D006801:Humans; D008297:Male; D008875:Middle Aged; D017534:Radial Artery / Q000601:surgery*; D012189:Retrospective Studies; D014652:Vascular Diseases / Q000209:etiology