title: The transradial approach is associated with lower risk of adverse outcomes following percutaneous coronary intervention: a single-center experience.
abstract: OBJECTIVE
  We sought to test the hypothesis that the transradial approach is associated with lower risk of adverse outcomes following percutaneous coronary intervention (PCI) compared to the transfemoral approach, and to examine whether the adoption of the transradial approach could result in improved quality of care for PCI in a single-center practice.
  
  
  BACKGROUND
  Although previous research has suggested that the transradial approach is associated with lower risk of adverse outcomes following PCI, it is not widely used in the United States.
  
  
  METHODS
  We identified 462 transradial and 625 transfemoral PCI cases that were treated at our center between January 2007 and March 2009. The differences between the transradial and transfemoral approaches in risks of in-hospital mortality, bleeding, and vascular complications as well as post-procedural lengths of stay were examined.
  
  
  RESULTS
  The risk of bleeding was significantly lower in the transradial group (2.60%) than the transfemoral group (6.08%); the adjusted odds ratio (OR) was 0.34 [95% confidence interval (CI), 0.17-0.68; p = 0.002]. The risk of vascular complications was also significantly lower (0% versus 1.44%, respectively; OR, 0.11; 95% CI, 0-0.68; p = 0.01). The observed in-hospital mortality rate was lower for the transradial approach (0.87% versus 2.24%), but the difference was not statistically significant (adjusted OR, 0.55; 95% CI, 0.14-2.10; p = 0.38). Same-day discharges were more common in the transradial patients (14.2% versus 2.2%; adjusted OR, 15.6; 95% CI, 7.76-31.44; p < 0.0001).
  
  
  CONCLUSIONS
  The risks of bleeding and vascular complications are lower for the transradial approach. Adopting the transradial approach may lead to improved care for PCI.
authors.affiliation: Department of Public Health Sciences, Penn State Hershey College of Medicine, 600 Centerview Drive, Hershey, PA 17033, USA. chuntao.wu@psu.edu
authors.forename: Chuntao
authors.initials: C
authors.lastname: Wu
authors.forename: Duanping
authors.initials: D
authors.lastname: Liao
authors.forename: Anne-Marie
authors.initials: AM
authors.lastname: Dyer
authors.forename: Helen
authors.initials: H
authors.lastname: Chen
authors.forename: Ian C
authors.initials: IC
authors.lastname: Gilchrist
mesh_terms: D000368:Aged; D000369:Aged, 80 and over; D015906:Angioplasty, Balloon, Coronary / Q000009:adverse effects* / Q000379:methods*; D003324:Coronary Artery Disease / Q000628:therapy*; D005260:Female; D005263:Femoral Artery; D006470:Hemorrhage / Q000453:epidemiology; D017052:Hospital Mortality; D006801:Humans; D008297:Male; D008875:Middle Aged; D017063:Outcome Assessment, Health Care; D011787:Quality of Health Care; D017534:Radial Artery; D012189:Retrospective Studies; D012307:Risk Factors; D057772:Vascular System Injuries / Q000453:epidemiology