A comparison of the transradial and the transfemoral approach in chronic total occlusion percutaneous coronary intervention.
BACKGROUND
Transradial coronary intervention is a safe and effective method of percutaneous revascularization. Furthermore, the indications for transradial percutaneous coronary intervention (PCI) are expanding. However, there is limited data on the efficacy and the safety of the transradial approach for chronic total occlusion (CTO) PCI.


METHODS
We examined 468 patients who underwent CTO PCI between January 2003 and December 2005, and compared the radial (318 patients) and the femoral (150 patients) approach.


RESULTS
Baseline demographics, lesion location, and the vessel treated were similar in both groups. Angiographic success was 82% in radial versus 86% in femoral group, P = 0.28, similar in both groups. Total fluoroscopy time (24.49 +/- 13.18 vs. 24.07 +/- 14.12 min, P = 0.36), total procedure time (54.22 +/- 25.35 vs. 60.23 +/- 28.15 min, P = 0.23), and the use of total contrast volume (395.54 +/- 180.25 vs. 406.15 +/- 173.98 ml, P = 0.27) were similar in radial and femoral group, respectively. In hospital MACE [radial: 12 MI (3.8%) vs. femoral: 1 death (0.7%) and 5 MI (3.5%), P = 0.26] were similar in both groups. Access site vascular complications [radial: 11 (3.5%) vs. femoral: 17 (11.3%), P <or= 0.001] were significantly less in radial group.


CONCLUSIONS
The radial approach in CTO PCI is as fast and successful as the femoral approach with comparable in hospital MACE. However, there are far less access site complications with radial approach.
Rathore
Sudhir
S
Department of Cardiology, Liverpool Heart and Chest Hospital, Liverpool, UK. sudhirrathore@hotmail.com
Hakeem
Abdul
A
Pauriah
Maheshwar
M
Roberts
Elved
E
Beaumont
Andrew
A
Morris
John L
JL
D000368:Aged; D015906:Angioplasty, Balloon, Coronary / Q000009:adverse effects / Q000379:methods* / Q000401:mortality; D002908:Chronic Disease; D003287:Contrast Media; D017023:Coronary Angiography; D054059:Coronary Occlusion / Q000000981:diagnostic imaging / Q000401:mortality / Q000628:therapy*; D005260:Female; D005263:Femoral Artery / Q000000981:diagnostic imaging; D006470:Hemorrhage / Q000209:etiology; D017052:Hospital Mortality; D006801:Humans; D007902:Length of Stay; D008297:Male; D008875:Middle Aged; D009203:Myocardial Infarction / Q000209:etiology; D017534:Radial Artery / Q000000981:diagnostic imaging; D011829:Radiation Dosage; D015641:Radiography, Interventional; D012189:Retrospective Studies; D013997:Time Factors; D016896:Treatment Outcome
D003287:Contrast Media