Comparision of pain levels of transradial versus transfemoral coronary catheterization: a prospective and randomized study.
OBJECTIVE
The aim of the present study was to assess access site pain levels of patients undergoing coronary catheterization via transradial route.


METHODS
We performed a prospective and randomized study in which 408 patients underwent coronary angiography (CAG) and/or percutaneous coronary intervention (PCI) via transradial approach (TRA) and 428 patients underwent CAG and/or PCI via transfemoral approach (TFA). Pain levels of patients were assessed with Visual Analog Scale (VAS) after catheterization and at 30 days. Student-t, Mann-Whitney U and chi-square tests were used for statistical analysis.


RESULTS
Patients in the TRA group showed higher VAS scores than those in TFA group after catheterization [CAG alone, 3 (2-5) vs. 1 (1-3), p<0.0001; PCI, 4 (2-6) vs. 2 (1-3), p<0.0001, respectively]. One month later, patients in TRA group also showed higher VAS scores than those in TFA group [CAG alone, 1 (0-1) vs. 0 (0-1), p<0.0001; PCI, 1 (0-2) vs. 0 (0-1), p<0.0001, respectively]. By the ROC analysis in TRA group, a level of BMI <24.3 kg/m2 predicted unacceptable pain with a 87.3% sensitivity and 91.6% specificity [area under curve (AUC): 0.875, 95% CI: 0.839-0.906, p<0.0001], while a wrist circumference <16.7 cm predicted unacceptable pain with 84.6% sensitivity and 89.8% specificity (AUC: 0.900, 95% CI: 0.867-0.928, p<0.0001).


CONCLUSIONS
The current study suggests that a radial approach for CAG and PCI in patients with a low BMI and small wrist circumference may cause more access site pain as compared with a femoral approach.
Department of Cardiology, Faculty of Medicine, Adıyaman University; Adıyaman-Turkey. erdalakturk@hotmail.com.
Erdal
E
Aktürk
Ertuğrul
E
Kurtoğlu
Necip
N
Ermiş
Nusret
N
Açıkgöz
Jülide
J
Yağmur
Mehmet Sait
MS
Altuntaş
Hasan
H
Pekdemir
Ramazan
R
Ozdemir
D054058:Acute Coronary Syndrome / Q000000981:diagnostic imaging / Q000628:therapy*; D017023:Coronary Angiography; D005260:Female; D005263:Femoral Artery; D006801:Humans; D008297:Male; D008875:Middle Aged; D010146:Pain / Q000517:prevention & control*; D010147:Pain Measurement; D062645:Percutaneous Coronary Intervention / Q000379:methods*; D011446:Prospective Studies; D017534:Radial Artery; D016896:Treatment Outcome