title: RAndomized Comparison of raDIal vs. femorAL Access for Routine Catheterization of Heart Transplant Patients (RADIAL-heart transplant study).
abstract: Although a transradial approach (TRA) is considered feasible in many clinical situations, no data are available in patients undergoing orthotopic heart transplantation (OHT). Our goal was to randomly compare TRA versus a transfemoral approach (TFA) in this clinical setting. This single-center, prospective, randomized trial was conducted from January to November 2006, and all OHT patients scheduled for a control coronary angiography were randomized to receive TRA or TFA. The primary endpoint was the amount of contrast used during the procedure. The participating interventional cardiologists were intermediate-volume radial operators, and this was their initial experience of TRA in OHT patients. The analysis was performed according to the intention-to-treat principle. Overall, 49 patients (mean age, 55 ± 13 years; 74% male) were included in the trial: 26 patients were assigned to TRA, and 23 were assigned to TFA. A higher amount of contrast (147 mL [range, 113-175 mL] vs 105 mL [range, 86-127 mL]; P = .009), a longer fluoroscopy time (9.2 minutes [range, 6-12 minutes] vs 3.5 minutes [range, 3-5 minutes]; P < .001), a trend toward increased number of catheters used for left ostium cannulation, and a higher crossover rate (19% vs 0%; P = .03) were associated with TRA compared with TFA. Furthermore, patients treated with TRA exhibit a shorter hospital stay (6 [range 4-8]) compared with the other group (26 [range 24-28]) (P < .001). There were no significant differences between the 2 groups regarding total procedural time, and no vascular complications were reported in either group. For these operators with their first experience of TRA in OHT patients, TFA seemed to be more efficient.
authors.affiliation: Catholic University of Sacred Heart, Cardiology Department, Rome, Italy.
authors.forename: G
authors.initials: G
authors.lastname: Scalone
authors.affiliation: Thorax Institute, Department of Cardiology, Institut d'Investigacions Biomediques Agust Pi i Sunyer (IDIBAPS), Hospital Clinic, Barcelona, Spain.
authors.forename: S
authors.initials: S
authors.lastname: Brugaletta
authors.affiliation: Thorax Institute, Department of Cardiology, Institut d'Investigacions Biomediques Agust Pi i Sunyer (IDIBAPS), Hospital Clinic, Barcelona, Spain.
authors.forename: V
authors.initials: V
authors.lastname: Martín-Yuste
authors.affiliation: Department of Cardiology, Hospital de la Santa Creu i Sant Pau, Barcelona, Spain.
authors.forename: F
authors.initials: F
authors.lastname: Seixo
authors.affiliation: Department of Cardiology, Hospital de la Santa Creu i Sant Pau, Barcelona, Spain.
authors.forename: C
authors.initials: C
authors.lastname: Cotes
authors.affiliation: Thorax Institute, Department of Cardiology, Institut d'Investigacions Biomediques Agust Pi i Sunyer (IDIBAPS), Hospital Clinic, Barcelona, Spain.
authors.forename: O
authors.initials: O
authors.lastname: Gómez-Monterrosas
authors.affiliation: Thorax Institute, Department of Cardiology, Institut d'Investigacions Biomediques Agust Pi i Sunyer (IDIBAPS), Hospital Clinic, Barcelona, Spain.
authors.forename: L
authors.initials: L
authors.lastname: Alvarez-Contreras
authors.affiliation: Department of Cardiology, Hospital de la Santa Creu i Sant Pau, Barcelona, Spain.
authors.forename: M
authors.initials: M
authors.lastname: Campreciós
authors.affiliation: Department of Cardiology, Hospital de la Santa Creu i Sant Pau, Barcelona, Spain.
authors.forename: S
authors.initials: S
authors.lastname: Mirabet
authors.affiliation: Department of Cardiology, Hospital de la Santa Creu i Sant Pau, Barcelona, Spain.
authors.forename: V
authors.initials: V
authors.lastname: Brossa
authors.affiliation: Thorax Institute, Department of Cardiology, Institut d'Investigacions Biomediques Agust Pi i Sunyer (IDIBAPS), Hospital Clinic, Barcelona, Spain. Electronic address: masabate@clinic.ub.es.
authors.forename: M
authors.initials: M
authors.lastname: Sabaté
mesh_terms: D000368:Aged; D002404:Catheterization / Q000379:methods*; D017023:Coronary Angiography / Q000379:methods*; D005260:Female; D005263:Femoral Artery; D016027:Heart Transplantation; D006801:Humans; D007902:Length of Stay / Q000639:trends; D008297:Male; D008875:Middle Aged; D011446:Prospective Studies; D017534:Radial Artery; D016896:Treatment Outcome