title: Comparisons of Clinical and Procedural Outcomes Between Transradial and Transfemoral Approaches in Percutaneous Coronary Intervention (from the Korean Transradial Intervention Prospective Registry).
abstract: As few studies have reported the impact of transradial interventions (TRIs) versus transfemoral interventions (TFIs) on percutaneous coronary interventions using real-world registry data, we compared the clinical and procedural outcomes between TRIs and TFIs in the Korean Transradial Intervention Prospective Registry. Patients undergoing percutaneous coronary interventions were consecutively registered from February 2014 to July 2014 in this multicenter registry. Composite events were evaluated for all-cause deaths, nonfatal myocardial infarctions, and repeat revascularizations within 30 days. Nonlesion complications included access site complications and bleeding events. A total of 1,225 patients (232 for TFIs and 993 for TRIs) were analyzed. All-cause deaths and composite events were more frequent in the TFI group than in the TRI group. Procedure failures and nonlesion complications were also more frequent in the TFI group, whereas lesion complication rates were similar in the 2 groups. Procedure times were not different between the 2 groups, whereas fluoroscopy times were longer and contrast volumes were larger in the TFI group. However, in a propensity score-matched cohort, all-cause deaths, composite events, procedure failures, and lesion and nonlesion complications were not different between the 2 groups. In contrast, in the matched cohort, the procedure and fluoroscopy times were longer and the contrast volumes were larger in the TFI group. In conclusion, TRI was as effective and safe as TFI in terms of short-term clinical outcomes, procedure success rates, and complication rates, whereas TRI was more effective for reducing procedure times and hazardous exposure to radiation and contrast media.
authors.affiliation: Division of Cardiology, Department of Internal Medicine, College of Medicine, Hanyang University, Seoul, South Korea.
authors.forename: Young-Hyo
authors.initials: YH
authors.lastname: Lim
authors.affiliation: Department of Cardiology, Sungae Hospital, Seoul, South Korea.
authors.forename: Yonggu
authors.initials: Y
authors.lastname: Lee
authors.affiliation: Division of Cardiology, Department of Internal Medicine, College of Medicine, Hanyang University, Seoul, South Korea.
authors.forename: Jinho
authors.initials: J
authors.lastname: Shin
authors.affiliation: Division of Cardiology, Department of Internal Medicine, College of Medicine, Yonsei University Wonju Severance Christian Hospital, Wonju, South Korea.
authors.forename: Junghan
authors.initials: J
authors.lastname: Yoon
authors.affiliation: Division of Cardiology, Department of Internal Medicine, College of Medicine, Yonsei University Wonju Severance Christian Hospital, Wonju, South Korea. Electronic address: carshlee@yonsei.ac.kr.
authors.forename: Seung-Hwan
authors.initials: SH
authors.lastname: Lee
authors.affiliation: Division of Cardiology, Department of Internal Medicine, College of Medicine, Korea University Guro Hospital, Seoul, South Korea.
authors.forename: Seung-Woon
authors.initials: SW
authors.lastname: Rha
authors.affiliation: Division of Cardiology, Department of Internal Medicine, College of Medicine, Chungnam National University Hospital, Daejeon, South Korea.
authors.forename: Jae-Hwan
authors.initials: JH
authors.lastname: Lee
authors.affiliation: Division of Cardiology, Department of Internal Medicine, College of Medicine, Chonnam National University Hospital, Gwangju, South Korea.
authors.forename: Myung Ho
authors.initials: MH
authors.lastname: Jeong
authors.affiliation: Division of Cardiology, Department of Internal Medicine, College of Medicine, Kangwon National University Hospital, Chuncheon, South Korea.
authors.forename: Byung-Ryul
authors.initials: BR
authors.lastname: Cho
authors.affiliation: Division of Cardiology, Department of Internal Medicine, College of Medicine, Hanyang University, Seoul, South Korea. Electronic address: kskim@hanyang.ac.kr.
authors.forename: Kyung-Soo
authors.initials: KS
authors.lastname: Kim
mesh_terms: D000368:Aged; D006328:Cardiac Catheterization / Q000379:methods*; D002423:Cause of Death / Q000639:trends; D017023:Coronary Angiography; D003324:Coronary Artery Disease / Q000000981:diagnostic imaging / Q000401:mortality / Q000601:surgery*; D005260:Female; D005263:Femoral Artery; D005500:Follow-Up Studies; D006801:Humans; D015994:Incidence; D008297:Male; D062645:Percutaneous Coronary Intervention / Q000379:methods*; D011183:Postoperative Complications / Q000453:epidemiology*; D057216:Propensity Score; D011446:Prospective Studies; D017534:Radial Artery; D012042:Registries; D056910:Republic of Korea / Q000453:epidemiology; D015996:Survival Rate / Q000639:trends; D013997:Time Factors; D016896:Treatment Outcome