title: Transradial versus transfemoral approach for coronary angiography and angioplasty - A prospective, randomized comparison.
abstract: PCI has been done traditionally through transfemoral route. But now transradial and transbrachial routes are also coming up in practice. We compared transradial versus transfemoral routes for ease of operability, time for procedure, complications, and failure rates through a prospective study.
  
  
  
  Four hundred Patients admitted in department of cardiology for percutaneous interventions were enrolled in the study. 200 patients were assigned to each group randomly. A single team did all the procedures. Pre procedure, intra procedure and post procedure data of all the patients was collected, tabulated and analysed properly.
  
  
  
  Access time (6.0 ± 1vs 4.2 ± 0.7; P =0.001); Fluoroscopy time and overall procedure time (29 ± 11.3 Vs. 27.3 ± 12.4 min) were more with trans radial than transfemoral route, respectively. The most common post procedure complication, ecchymosis was seen in 20.5% in transfemoral group compared to 12.5% in transradial group (P 0.031). Thrombophelibites (17.5 VS 8%, P0.004); Hematoma (14.5 Vs 0%, P 0.005); post procedure access bleed (7 VS 3%, P 0.039) were seen in transfemoral than transradial group, respectively. Failure rates were almost similar. None of our patients had post procedure myocardial infarction, stroke, acute renal failure and infections.
  
  
  
  Transradial approach of PCI is better than transfemoral route with respect to complications like bleeding, haematoma formation, thrombophelebites and ecchymosis is concerned. However access and fluoroscopic time is more with the former. We recommend the transradial route for PCI.
  
  
  
  Trial is retrospectively registered in ClinicalTrials.gov with the Identifier: NCT02983721 , Date of registration is December 2, 2016.
authors.affiliation: Internal Medicine, Sher-i-Kashmir Institute of Medical Sciences, Srinagar, India.
authors.forename: Fayaz Ahmad
authors.initials: FA
authors.lastname: Bhat
authors.affiliation: Internal Medicine, Sher-i-Kashmir Institute of Medical Sciences, Srinagar, India. khalidchangal@gmail.com.|Present affiliation: Mercy St. Vincent's Medical Center, Toledo, OH, USA. khalidchangal@gmail.com.
authors.forename: Khalid Hamid
authors.initials: KH
authors.lastname: Changal
authors.affiliation: Internal Medicine, Sher-i-Kashmir Institute of Medical Sciences, Srinagar, India.
authors.forename: Hameed
authors.initials: H
authors.lastname: Raina
authors.affiliation: Internal Medicine, Sher-i-Kashmir Institute of Medical Sciences, Srinagar, India.
authors.forename: Nisar Ahmad
authors.initials: NA
authors.lastname: Tramboo
authors.affiliation: Internal Medicine, Sher-i-Kashmir Institute of Medical Sciences, Srinagar, India.
authors.forename: Hilal Ahmad
authors.initials: HA
authors.lastname: Rather
mesh_terms: D000368:Aged; D006328:Cardiac Catheterization / Q000009:adverse effects / Q000379:methods*; D002406:Catheterization, Peripheral / Q000009:adverse effects / Q000379:methods*; D017023:Coronary Angiography / Q000009:adverse effects / Q000379:methods*; D003324:Coronary Artery Disease / Q000000981:diagnostic imaging* / Q000628:therapy*; D005260:Female; D005263:Femoral Artery / Q000000981:diagnostic imaging; D006801:Humans; D007194:India; D008297:Male; D008875:Middle Aged; D062645:Percutaneous Coronary Intervention / Q000009:adverse effects / Q000379:methods*; D011237:Predictive Value of Tests; D011446:Prospective Studies; D011677:Punctures; D017534:Radial Artery / Q000000981:diagnostic imaging; D011829:Radiation Dosage; D000069079:Radiation Exposure; D015641:Radiography, Interventional; D012307:Risk Factors; D013997:Time Factors; D016896:Treatment Outcome
keywords: Angiography; Transfemoral; Transradial