[Transradial diagnostic and interventional cardiac catheterization in daily practice: advantages, efficacy and safety].
The transfemoral approach is still considered as the standard technique for cardiac catheterization. The transradial approach is associated with a lower incidence of vascular access site complications and shorter hospital stay, although it is more demanding and requires a longer learning curve.


OBJECTIVE
To assess advantages, efficacy and safety of the transradial versus transfemoral cardiac catheterization in patients with high risk to develop vascular complications.


METHODS
Single center, case series study. Catheterization data, vascular complications and rehospitalizations were collected prospectively. The site of access was determined by the operator preference, patient suitability and the risk for local bleeding.


RESULTS
From November 2005 through August 2007 a total of 3084 consecutive cardiac catheterization were performed: 871 (28%) transradial and 2213(72%) transfemoral. The transradial group included higher rates of patients with high risk to develop entry site vascular complications (obese, anticoagulation therapy and peripheral vascular disease) than the femoral group (p < 0.0001). Crossover to alternative access site was 4.5% in the radial versus 0.03% in the femoral group (OR 3.17, CI 95% 2.78 to 3.60, p < 0.0001). Fluoroscopy time was 2 minutes higher in the radial group (p = 0.043). Entry site vascular complications were significantly lower in the radial compared to femoral group, 0.03% versus 3.1% respectively (OR 0.1, CI 0.06 to 0.35, p < 0.0001). Hospital stay was 1.32 days shorter in the radial group (p < 0.0001). The increased number of radial catheterization was correlated significantly with decreased incidence of vascular complications (Pearson's rp = -0.927, p < 0.0001).


CONCLUSIONS
Transradial cardiac catheterization is a safe and effective approach to reduce vascular complications in high risk patients.
Suleiman
Khalid
K
Heart Institute, Ha'Emek Medical Center, Afula, Israel. Suleiman_kh@clalit.org.il
Feldman
Alexsander
A
Ilan-Bushari
Limor
L
Turgeman
Yoav
Y
D000368:Aged; D000925:Anticoagulants / Q000627:therapeutic use; D001241:Aspirin / Q000627:therapeutic use; D006328:Cardiac Catheterization / Q000009:adverse effects / Q000379:methods* / Q000592:standards; D016001:Confidence Intervals; D005260:Female; D006495:Heparin, Low-Molecular-Weight / Q000627:therapeutic use; D006801:Humans; D008297:Male; D008875:Middle Aged; D016017:Odds Ratio; D017534:Radial Artery; D012189:Retrospective Studies; D012449:Safety; D015912:Thrombolytic Therapy; D016896:Treatment Outcome
D000925:Anticoagulants; D006495:Heparin, Low-Molecular-Weight; D001241:Aspirin