SAFETY, EFFICACY AND FEASIBILITY OF TRANS RADIAL APPROACH IN COMPARISON WITH TRANSFEMORAL APPROACH IN PATIENTS UNDERGOING CORONARY CATHETERIZATION

Abstract

Background:Percutaneous Coronary Intervention has been done traditionally through Transfemoral route. Trans Radial route is coming up in the practice. We compared Trans Radial with Transfemoral accesses for ease of operability, time of procedure, complications, and failure rates through a cross sectional study. Objectives:To assess the efficacy, feasibility, safety and procedural variables in Trans radial approach compared with the Transfemoral Approach in patients undergoing coronary artery catheterization. Patients and Methods:A total of 180 patients with both chronic and acute coronary syndromes were enrolled in this study, one hundred forty 140 cases with Radial, 28 of whom were crossed to Femoral access (hence 112 Radials with 108 Right Radial and 4 Left Radial) and 68 cases with Femoral access. Results:Procedural time between Trans Radial and Transfemoral accesses were similar (17.39±10.33 vs 19.68±16.62 minutes P-value 0.36) respectively while among Femoral crossover group was higher (33.50±20.30 minutes P-value 0.01). The Fluoroscopy time was (5.51±4.70 in Trans Radial Vs. 7.18 ±7.65 minutes in Transfemoral P-value 0.07) were similar in both groups. Post procedure access site complications seen in (9% in Trans Radial compared to 7.35% in Transfemoral, P-value 0.048), Access site Hematoma being the most common one (6.25% in Trans Radial vs 4.4% in Transfemoral), Non-flow limiting dissections occurred in (0.89% in Trans Radial VS 1.4% Transfemoral), Radial artery perforation occurred in 1.78%, 1.4% of patients in Femoral group had Femoral artery perforation and had major bleeding. Conclusion:The overall local complications were lower in Transfemoral access, except for major bleeding which is still a big concern. Both vascular Access techniques should not be considered opposite or mutually exclusive, but rather provide the Interventionist a wide spectrum of the therapeutic options.