Comparison of Clinical Outcomes between the Right and Left Radial Artery Approaches from the Korean Transradial Coronary Intervention Registry.
OBJECTIVE
Transradial intervention (TRI) shows anatomical and technical differences between the right radial approach (RRA) and left radial approach (LRA). The aim of this study was to evaluate the efficacy and safety using LRA, compared with RRA.


METHODS
A total of 1653 consecutive patients who underwent TRI from November 2004 to October 2010 were enrolled in the Korean multicenter TRI registry. The patients were divided into two groups: the RRA group (n=792 patients) and the LRA group (n=861 patients). To adjust for any potential confounders, propensity score matched (PSM) analysis was performed (C-statistic: 0.726). After PSM, a total of 1100 patients were enrolled for analysis.


RESULTS
After PSM, the RRA group exhibited a larger contrast volume (259.3±119.6 mL vs. 227.0±90.7 mL, p<0.001), a longer fluoroscopic time (22.5±28.0 minutes vs. 17.1±12.6 minutes) and higher access site change (12.3% vs. 1.0%, p<0.001) than the LRA group. Meanwhile, the LRA group showed a shorter procedure time (49.2±30.4 minutes vs. 55.4±28.7 minutes, p=0.003) than the RRA group. After PSM, in-hospital complications and 12-month cumulative clinical outcomes were similar between the two groups.


CONCLUSIONS
Of the two TRI methods, LRA was associated with better procedural efficacy, including shorter procedural time, smaller contrast volume, and less access site change than RRA. However, both methods showed similar 12-month cumulative clinical outcomes. Therefore, LRA was deemed superior to RRA in terms of procedural feasibility without a significant difference in clinical outcomes.
Division of Cardiology, Departement of Internal Medicine, Cardiovascular Center, Nowon Eulji Medical Center, Eulji University, Seoul, Korea.
Ji Young
JY
Park
Cardiovascular Center, Korea University Guro Hospital, Seoul, Korea. swrha617@yahoo.co.kr.
Seung Woon
SW
Rha
Cardiovascular Center, Korea University Guro Hospital, Seoul, Korea.
Byong Geol
BG
Choi
Cardiovascular Center, Korea University Guro Hospital, Seoul, Korea.
Dong Ju
DJ
Oh
Cardiovascular Center, Korea University Guro Hospital, Seoul, Korea.
Cheol Ung
CU
Choi
Division of Cardiology, Departement of Internal Medicine, Cardiovascular Center, Yonsei University Wonju Hospital, Wonju, Korea.
Young Jin
YJ
Youn
Division of Cardiology, Departement of Internal Medicine, Cardiovascular Center, Yonsei University Wonju Hospital, Wonju, Korea.
Junghan
J
Yoon
D000368:Aged; D015906:Angioplasty, Balloon, Coronary / Q000009:adverse effects / Q000379:methods* / Q000401:mortality; D005260:Female; D005471:Fluoroscopy; D006801:Humans; D008297:Male; D008875:Middle Aged; D009203:Myocardial Infarction / Q000401:mortality / Q000628:therapy*; D062645:Percutaneous Coronary Intervention / Q000379:methods*; D017534:Radial Artery; D012042:Registries; D012189:Retrospective Studies; D018570:Risk Assessment; D012307:Risk Factors; D013997:Time Factors; D016896:Treatment Outcome
Percutaneous coronary intervention; radial artery; treatment outcome