Comparison of Safety of Radial and Femoral Approaches for Coronary Catheterization in Interventional Cardiology
Wojciech Samul, Anna Turowska, Przemysław Jerzy Kwasiborski, Paweł Kowalczyk, Andrzej Cwetsch
Department of Invasive Cardiology, Military Institute of Medicine, Warsaw, Poland
Med Sci Monit 2015; 21:1464-1468
The femoral approach has been the preferably used access in interventional cardiology as well for coronary diagnostics as for percutaneous coronary intervention, being perceived as easy and facilitating quick access with relatively low risk. Due to the results of the latest studies, however, the radial approach has become increasingly popular. The aim of this study was a safety analysis of cardiological interventional procedures (i.e., coronarography and PCI) according to the vessel approach.
Material and Methods: The 204 coronary interventions done in our Department of Interventional Cardiology were retrospectively analyzed. All the procedures were classified according to femoral or radial access. The incidence of local complications (e.g., major bleedings and hematomas) was assessed as well as the volume of contrast agent administered during the procedure and the radiation dose.
Results: It has been shown that radial approach, which is obviously more comfortable for patients, reduces the risk of local complications (0 vs. 2.97% and 0 vs. 3.96%) and does not lead to increased radiation exposure (p=0.88). However, there could be a larger volume of contrast agent administered (p=0.029), which in some cases could increase the risk of contrast-induced nephropathy.
Conclusions: The radial approach should be recommended as a first choice because it is safer than the classical femoral approach, but one must be cautious in choosing radial approach patients with renal insufficiency.
Keywords: Cardiac Catheterization - methods, Cardiovascular Diseases - therapy, Comorbidity, Contrast Media - adverse effects, Coronary Angiography - methods, Femoral Artery, Kidney Diseases - prevention & control, Pain - prevention & control, Percutaneous Coronary Intervention - methods, Radial Artery - injuries, Radiation Dosage, Radiology, Interventional, Risk