title: Rapid cycle change to predominantly radial access coronary angiography and percutaneous coronary intervention: effect on vascular access site complications.
abstract: OBJECTIVE
  This study sought to evaluate the safety and feasibility of all operators at a single center changing from predominantly femoral to radial access for coronary percutaneous procedures.
  
  
  BACKGROUND
  The radial artery is currently regarded as a useful vascular access site for coronary angiography and percutaneous coronary intervention (PCI). The reduction in local vascular access complications is thought to be a major advantage of the radial route. Despite this, the technique is used less frequently possibly reflecting concerns by cardiologists about the feasibility of using radial access as a preferred option.
  
  
  METHODS
  A retrospective study of 1004 consecutive patients who underwent coronary angiography with or without PCI was analyzed. Procedure details and clinical outcomes were assessed according to the radial or femoral approaches.
  
  
  RESULTS
  The success rate for cardiac catheterization via the radial approach was 97.4% (815/837) and the femoral approach was 98.8% (165/167). The procedural failure rate for radial access was not different from the femoral route [2.6% vs. 1.2%; odds ratio (OR), 2.26; 95% confidence interval (CI), 0.53-9.71; P = 0.41]. Major access site complications occurred in 0.25% patients in the radial group compared with 4.8% patients in the femoral group [OR, 0.05 (95% CI, 0.01-0.23); P < 0.0001].
  
  
  CONCLUSIONS
  The radial approach has a high rate of success and is associated with fewer major local vascular access site complications than the femoral route. These results can be achieved early in the operator learning curve of low to medium volume operators.
authors.affiliation: Department of Cardiology, Dunedin Hospital, Dunedin, New Zealand.
authors.forename: Kugathasan
authors.initials: K
authors.lastname: Nadarasa
authors.forename: M Clare
authors.initials: MC
authors.lastname: Robertson
authors.forename: Cheuk-Kit
authors.initials: CK
authors.lastname: Wong
authors.forename: Belinda K W
authors.initials: BK
authors.lastname: Green
authors.forename: Victor H T
authors.initials: VH
authors.lastname: Chen
authors.forename: Gerard T
authors.initials: GT
authors.lastname: Wilkins
authors.forename: Michael J A
authors.initials: MJ
authors.lastname: Williams
mesh_terms: D000368:Aged; D015906:Angioplasty, Balloon, Coronary / Q000009:adverse effects / Q000379:methods*; D006328:Cardiac Catheterization / Q000009:adverse effects / Q000379:methods*; D002983:Clinical Competence; D017023:Coronary Angiography / Q000009:adverse effects / Q000379:methods*; D005240:Feasibility Studies; D005260:Female; D005263:Femoral Artery; D006470:Hemorrhage / Q000209:etiology / Q000517:prevention & control*; D006801:Humans; D059032:Learning Curve; D008297:Male; D008875:Middle Aged; D009520:New Zealand; D016017:Odds Ratio; D011677:Punctures; D017534:Radial Artery; D012189:Retrospective Studies; D018570:Risk Assessment; D012307:Risk Factors; D013997:Time Factors; D016896:Treatment Outcome