| More

Radial versus femoral access in cardiac catheterization and angioplasty. a comparative study

Views: 231 Downloads: 186
Georgia Mavrogianni, Evaggelia Karantzoula, Georgia Toulia, Vasilios Kiriakopoulos, Olga Kadda
Georgia Mavrogianni, Evaggelia Karantzoula, Georgia Toulia, Vasilios Kiriakopoulos, Olga Kadda


Introduction: The radial artery’s use for performing cardiac catheterization, angiography and angioplasty of the coronary vessels, is an alternative way versus the access widely utilized femoral artery.
Aim: The aim of this study was to assess the potential advantages of radial versus femoral access.
Material and Method: The study population was 202 patients, who were referred to coronary angiography or intervention coronary angioplasty.Statistical analysis was performed using the statistical package SPSS ver.18. For evaluation of pain was used Visual Numeric Pain Intensity Scale (visual analogue scale, VAS), which comprises using a calibrated scale of 0- 10.
Results: From 1 to 30 May 2014 underwent coronary angiography in 202 patients, of whom 112 (55.4%) with RA and 90 (44.6%) with FA.Patients in the RA group showed higher VAS scores (1 ± 0.1) than those in FA group after catheterization (0.2 ± 0.4) P <0.001 + . In contrast, patients in the FA group had higher percentage of injuries / extravasations (13.3%) compared with the RA group (0.9%) P <0.001. Τhe time fluoroscopic was significantly higher in the FA (12.6 ± 10.5) compared to RA (7.6 ± 8.3) P <0.001. About the time of hospitalization, those who underwent femoral access were hospitalized significantly longer (2.6 ± 1.3) compared to patients who underwent radial access (2 ± 1.3) P <0.001+ .
Conclusions: The efficacy and safety of the method in combination with the smallest rate of local complications are able to establish access way first choice in hemodynamically laboratories.


Coronary angioplasty; transradial access; coronary artery disease

Full Text:



Shephered RFJ, Viestra RE. The history of balloon angioplasty, in Viestra RE, Holmes DR Jr(eds): Percutaneous transluminal coronary angioplasty. Philadelphia, FA Davis Co, 1987.

Bertrand OF, Rao SV, Pancholy S, Jolly SS, Rodes-Cabau J,Larose E, et al. Transradial approach for coronary angiography and interventions: results of the first international transradial practice survey. JACC Cardiovasc Interv 2010;3:1022-1031.

Doyle BJ, Rihal CS, Gastineau DA, Holmes DR Jr. Bleeding, blood transfusion, and increased mortality after percutaneous coronary intervention: implications for contemporary practice. J Am Coll Cardiol 2009; 53: 2019-2027.

Doyle BJ, Ting HH, Bell MR, et al. Major femoral bleeding complications after percutaneous coronary intervention:

incidence, predictors, and impact on longterm survival among 17,901 patients treated at the Mayo Clinic from 1994 to

JACC Cardiovasc Interv 2008; 1: 202- 209.

Refat Jabara, Radhica Gadesam, Lakshmana Pendyala, et al. Ambulatory discharge after transradial coronary intervention (the STRIDE Study). Am Heart J 2008; 156: 1141- 1146.

J.olly SS, Amlani S, Hamon M, Yusuf S, Mehta SR. Radial versus femoral access for coronary angiography or intervention and the impact on major bleeding and ischemic events: a systematic review and metaanalysis of randomized trials. Am Heart J 2009; 157: 132-140.

Cooper CJ, El-Shiekh RA, Cohen DJ, Blaesing L, Burket MW, Basu A et al. Effect of transradial access on quality of life and cost of cardiac catheterization: A randomized comparison. Am Heart J 1999; 138: 430- 436.

Chase AJ, Fretz EB, Warburton WP, Klinke WP, Carere RG, Pi D, et al. Association of the arterial access site at

angioplasty with transfusion and mortality: the M.O.R.T.A.L study (Mortality benefit Of Reduced Transfusion after percutaneous coronary intervention via the Arm or Leg). Heart 2008; 94: 1019-1025.

Cantor WJ, Mahaffey KW, Huang Z, Das P, Gulba DC, Glezer S et al. Bleeding complications in patients with acute

coronary syndrome undergoing early invasive management can be reduced with radial access, smaller sheath sizes, and timely sheath removal. Catheter Cardiovasc Interv 2007; 69: 73-83.

Tarantini G, Ramondo Α, Napodano, Bilato C, Buja P, Isabella G et al. Time delay-adjusted survival benefit of angioplasty over thrombolysis in acute myocardial infarction: influence of time from symptom onset. Ital Heart J 2004;5:844–850.

Romagnoli E, Biondi-Zoccai G, Sciahbasi A, Politi L, Rigattieri S, Pendenza G, et al. Radial Versus Femoral Randomized Investigation in ST-Segment Elevation Acute Coronary Syndrome: The RIFLE-STEACS (Radial Versus Femoral Randomized Investigation in ST-Elevation Acute Coronary J Am Coll Cardiol 2012;60(24):2481-2489.

Agostoni P, Biondi-Zoccai GG, de Benedictis ML, et al. Radial versus femoral approach for percutaneous coronary diagnostic and interventional procedures; Systematic overview and meta-analysis of randomized trials. J Am Coll Cardiol 2004; 44: 349-356.

Charanjit S. Rihal, David R. Holmes Jr. Transradial cardiac catheterization: Is femoral access obsolete? Am Heart J 1999; 138: 392-393.

Martial Hamon, Guillaume Coutance. Transradial Intervention for Minimizing Bleeding Complications in Percutaneous Coronary Intervention. Am J Cardiol 2009; 104: 55C-59C.

Camille Brasselet, Sophie Tassan, Pierre Nazeyrollas, et al. Randomized comparison of femoral versus radial approach for percutaneous coronary intervention using abciximab in acute myocardial infarction: results from the FARMI Trial. Heart 2007; 93: 1556-1561.

Rodrigo Bagur, Olivier F. Bertrand, et al. Comparison of Outcomes in Patients >70 Years Versus <70 Years After Transradial Coronary Stenting With Maximal Antiplatelet Therapy for Acute Coronary Syndrome,Am J Cardiol 2009;104:624-629.

Jonas Eichhӧfer, Eric Horlick, Joan Ivanov, et al. Decreased complication rates using the transradial compared to the transfemoral approach in percutaneous coronary intervention in the era of routine stenting and glycoprotein platelet IIb/ IIIa inhibitor use. Am Heart J 2008; 156: 864-870.

Aktόrk E, Kurtoğlu E, Ermiş N, Aηıkgφz N, YağmurJ , Altuntaş M, :Comparision of pain levels of transradial versus transfemoral coronary catheterization: a prospective and randomized study Anadolu Kardiyol Derg 2014; 14: 140-6

Jolly SS, Yusuf S, Cairns J, Niemelä K, Xavier D, Widimsky Pet al; on behalf of the RIVAL Steering committee. A randomized comparison of RadIal Vs. femorAL access for coronary intervention in ACS (RIVAL) Am Heart J 2011; 161: 254-260.

Amin AP, House JA, Safley DM, Chhatriwalla AK, Giersiefen H, Bremer A. Costs of transradial percutaneous coronary intervention. JACC Cardiovasc Interv 2013;6(8):827-34.

Lefevre T, Louvard Y. Description and management of difficult anatomy encountered during transradial intervention. In HamonM, McFadden E, editors. Transradial approach for cardiovascular interventions. Carpiquet: Europa Stethoscope Media; 203: 241-254


  • There are currently no refbacks.

Health and Research Journal