title: A multicentre comparison of transradial and transfemoral approaches for coronary angiography and PTCA in obese patients: the TROP registry.
abstract: OBJECTIVE
  The incidence of obesity is increasing continuously in industrial countries. Vascular complications after the transfemoral approach (TF) for either coronary angiography (CA) or angioplasty (PCI) are more frequent in this population. The transradial approach may decrease the risk of such complications.
  
  
  RESULTS
  We undertook a prospective, multicentre, European registry of overweight patients (BMI >/=35), undergoing CA and/or PCI in centres with broad experience in the transradial approach (TR). The vascular approach was left to the operator's discretion. The primary end point was the occurrence of access related complications resulting in delayed hospital discharge 555 patients, (age 60.8+/-10.9 years; males 57.3%; BMI: 38.5+/-3.6 kg/m2) were included in the study. Of these, 157 underwent the transfemoral approach and 398 the transradial. Total procedure time was significantly shorter for the transradial approach in these morbidly obese patients (TR: 35.5+/-25.8 min versus TF: 52.4+/-25.2 min, p=0.0001), and hospital stay after CA or PCI was significantly shorter in the transradial group (TR: 1.8+/-2.3 days versus TF: 2.5+/-4.3 days, p=0.04). Vascular complications delaying hospital discharge occurred in 0.8% of TR patients vs 5.1% TF patients. p=0.0009).
  
  
  CONCLUSIONS
  The rate of vascular complications in overweight patients after CA or PCI can be significantly decreased by the use of the transradial approach in centres with a large experience.
authors.affiliation: Hôpital Européen de Paris la Roseraie, Aubervilliers, France.
authors.forename: Hakim
authors.initials: H
authors.lastname: Benamer
authors.forename: Yves
authors.initials: Y
authors.lastname: Louvard
authors.forename: Marcelo
authors.initials: M
authors.lastname: Sanmartin
authors.forename: Orazio
authors.initials: O
authors.lastname: Valsecchi
authors.forename: David
authors.initials: D
authors.lastname: Hildick-Smith
authors.forename: Philippe
authors.initials: P
authors.lastname: Garot
authors.forename: Inga
authors.initials: I
authors.lastname: Narbute
authors.forename: Martial
authors.initials: M
authors.lastname: Hamon
authors.forename: Imre
authors.initials: I
authors.lastname: Ungi
authors.forename: Jacques
authors.initials: J
authors.lastname: Monsegu