title: The feasibility of percutaneous transradial coronary intervention for saphenous vein graft lesions and comparison with transfemoral route.
abstract: BACKGROUND
  Transradial PCI is rapidly expanding and is effective in complex lesion subset due to miniaturization of devices and accumulated clinical experience. However, the femoral route still remains the usual vascular route used for SVG PCI in most catheterization laboratories.
  
  
  METHODS
  We examined 115 consecutive patients undergoing SVG PCI between January 2003 and December 2005 and compared the radial (51 patients) and femoral (64 patients) approaches.
  
  
  RESULTS
  Baseline demographics, lesion location, and clinical indication were similar in both groups. GpIIbIIIa inhibitor usage was high in the radial group (78.4% vs. 53.1%, P < 0.01). Angiographic success was similar in both groups, 96% in the radial group vs. 96.8 in the femoral. Total fluoroscopy time (18.59 +/- 12.23 vs. 20.45 +/- 12.9), total procedure time (52.1 +/- 29.5 vs. 43.90 +/- 23.31 min), and the use of total contrast volume (357.0 +/- 174.0 vs. 346.0 +/- 157.0 ml) were similar in the radial and femoral groups, respectively. In-hospital MACE (radial: 2 MI [4.0%] vs. femoral: 1 death [1.6%] and 7 MI [11.0%], P < 0.01) were similar in both groups. Access site vascular complications (radial: 2 [4.0%] vs. femoral: 10 [11.0%], P < 0.001) were significantly less in the radial group.
  
  
  CONCLUSIONS
  The transradial approach for SVG PCI is feasible, safe, and as quick as the femoral approach. Procedural success is high with similar radiation and contrast exposure. In-hospital MI in the femoral group is high because of more-unstable patients. However, there are significantly lower vascular complications despite high use of platelet inhibitors in the radial approach.
authors.affiliation: Liverpool Heart and Chest Hospital, Liverpool, UK. sudhirrathore@hotmail.com
authors.forename: Sudhir
authors.initials: S
authors.lastname: Rathore
authors.forename: Elved
authors.initials: E
authors.lastname: Roberts
authors.forename: Abdul R
authors.initials: AR
authors.lastname: Hakeem
authors.forename: Maheshwar
authors.initials: M
authors.lastname: Pauriah
authors.forename: Andrew
authors.initials: A
authors.lastname: Beaumont
authors.forename: John L
authors.initials: JL
authors.lastname: Morris
mesh_terms: D000368:Aged; D015906:Angioplasty, Balloon, Coronary; D003324:Coronary Artery Disease / Q000628:therapy*; D005240:Feasibility Studies; D005260:Female; D005263:Femoral Artery; D006801:Humans; D008297:Male; D008875:Middle Aged; D009203:Myocardial Infarction / Q000628:therapy; D011446:Prospective Studies; D017534:Radial Artery; D012501:Saphenous Vein