Radial versus femoral approach for high-speed rotational atherectomy.
OBJECTIVE
The aim of this study was to compare in-hospital outcomes for patients undergoing high-speed rotational atherectomy (HSRA) via the radial and femoral route.


BACKGROUND
Transradial access is often avoided for HSRA because of concern over limitations on guide catheter size. No studies have compared a radial and femoral approach for HSRA.


METHODS
This is a retrospective comparison of in-hospital outcomes for 151 consecutive patients (75 radial, 76 femoral) undergoing HSRA.


RESULTS
Significantly smaller diameter guide catheters (6.3 +/- 0.5 Fr vs. 7.1 +/- 0.8 Fr, P < 0.001) and burrs (1.6 +/- 0.2 mm vs. 1.7 +/- 0.2 mm, P = 0.02) were used in the radial compared with the femoral group. Procedural success (93.3% vs. 94.7%, P = 0.75), procedure time (108.7 +/- 30.5 min vs. 112.8 +/- 35.0 min, P = 0.45), and patient radiation exposure (12125 +/- 8373 vs. 12118 +/- 7831 cGy cm(2), P = 1.00) were similar in radial and femoral groups. There was a trend in favor of radial artery access for major access site bleeding complications (0.0% vs. 5.3%, P = 0.12). The incidence of in-hospital death or myocardial infarction was low in both groups.


CONCLUSIONS
This study shows that radial artery access is a feasible, safe, and effective approach for HSRA. Overall complication rates are low and radial access may be associated with a lower risk of major bleeding complications compared with a femoral approach.
Watt
Jonathan
J
Department of Cardiology, Western Infirmary, Glasgow G11 6NT, Scotland.
Oldroyd
Keith G
KG
D000368:Aged; D017225:Atherectomy, Coronary / Q000009:adverse effects / Q000295:instrumentation / Q000379:methods* / Q000401:mortality; D006328:Cardiac Catheterization / Q000009:adverse effects / Q000295:instrumentation / Q000379:methods* / Q000401:mortality; D017023:Coronary Angiography; D003324:Coronary Artery Disease / Q000000981:diagnostic imaging / Q000401:mortality / Q000628:therapy*; D004867:Equipment Design; D005260:Female; D005263:Femoral Artery; D006470:Hemorrhage / Q000209:etiology; D017052:Hospital Mortality; D006801:Humans; D008297:Male; D008875:Middle Aged; D009203:Myocardial Infarction / Q000209:etiology; D017534:Radial Artery; D012189:Retrospective Studies; D018570:Risk Assessment; D013997:Time Factors; D016896:Treatment Outcome