Transradial versus transfemoral approach for coronary angiography and intervention in patients above 75 years of age
- 23 July 2008
- journal article
- research article
- Published by Wiley in Catheterization and Cardiovascular Interventions
- Vol. 72 (5), 629-635
- https://doi.org/10.1002/ccd.21696
Abstract
Aims: The transradial (TR) approach has potentially lower complication rates than transfemoral (TF) approach coronary angiography. However, it may be technically more challenging, especially in elderly patients with alterations in vascular anatomy. We thus determined success rates, procedural data, and complication rates of TR angiography in comparison to the TF approach in elderly patients in a randomized, prospective trial. Methods and results: Four hundred consecutive patients ≥75 years with known or suspected coronary artery disease were included in the study. After exclusion of 93 patients with contraindications to the radial approach, 152 patients were randomized to the TR and 155 to TF coronary angiography and intervention. In 13 patients randomized to TR, cross‐over to TF was necessary (9%). Total examination time was significantly longer for the TR approach (18.1 vs. 15.0 min, P = 0.009), but no difference was found for fluoroscopy time, number of catheters used, or amount of contrast agent. The rate of major complications (bleeding requiring surgery or transfusion, stroke) was 0% for TR and 3.2% for TF approach (P < 0.001). Minor complications occurred in 1.3% versus 5.8% of patients (P < 0.001). Conclusion: In elderly patients, TR coronary angiography and intervention has a high technical success rate and lower complication rates than the TF approach.Keywords
This publication has 18 references indexed in Scilit:
- Radial versus femoral approach for percutaneous coronary diagnostic and interventional procedures: Systematic overview and meta-analysis of randomized trialsJournal of the American College of Cardiology, 2004
- Transradial approach for coronary angioplasty in the setting of acute myocardial infarction: A dual‐center registryCatheterization and Cardiovascular Interventions, 2002
- Trial of invasive versus medical therapy in elderly patients with chronic symptomatic coronary-artery disease (TIME): a randomised trialThe Lancet, 2001
- Systematic use of transradial approach or suture of the femoral artery after angioplasty: Attempt at achieving zero access site complicationsCatheterization and Cardiovascular Interventions, 2000
- Effect of transradial access on quality of life and cost of cardiac catheterization: A randomized comparisonAmerican Heart Journal, 1999
- A Randomized Comparison of Percutaneous Transluminal Coronary Angioplasty by the Radial, Brachial and Femoral Approaches: The Access StudyJournal of the American College of Cardiology, 1997
- Long-term results after successful percutaneous transluminal coronary angioplasty in patients over 75 years of ageThe American Journal of Cardiology, 1996
- Risk of cardiac catheterization in patients aged />-80 years without previous cardiac surgeryThe American Journal of Cardiology, 1994
- Coronary arteriography 1984–1987: A report of the registry of the society for cardiac angiography and interventions. I. Results and complicationsCatheterization and Cardiovascular Diagnosis, 1989
- Percutaneous radial artery approach for coronary angiographyCatheterization and Cardiovascular Diagnosis, 1989