Occurrence of Bleeding Complications of Radial and Femoral Artery Routes in Patients Undergoing Percutanous Coronary Intervention

Background: Percutaneous coronary angiography and percutaneous trans-luminal coronary angioplasty are the standard diagnostic and therapeutic strategies for coronary artery disease [1]. Angiography/ percutaneous coronary intervention (PCI) is usually performed by the femoral and radial artery routes. However, the ulnar artery can also be used [2]. Conventionally, the femoral route has been favored for coronary angiography and percutaneous coronary intervention, but there is growing interest for radial access due to reduced hemorrhagic complications during and after the procedure. This is due to the fact that severe bleeding is considered a determinant of poor prognosis in patients with acute coronary syndrome [3]. In the current practice of interventional cardiology, it has been recognized that bleeding has become the most common early complication associated with PCI [4]. Objective: To determine the frequency of bleeding complications of radial and femoral artery routes (major bleeding and localized hematoma formation) in patients undergoing Percutanous Coronary Intervention. Setting: This cross sectional study Department of Cardiology, Cardiology, AFIC & National Institute of Heart Diseases Rawalpindi. Methodology: Patients fulfilling the inclusion criteria was recruited for the study after informed consent and explanation about risks and benefits of the procedure. Bleeding complications was determined in transradial or transfemoral access groups undergoing Percutanous Coronary Intervention. The data was gathered through a pre-tested questionnaire after informed consent. Every patient was given an ID, Privacy of the patient was ensured. Post procedure patient was examined immediately for localized swelling, hematoma formation and hemoglobin were assessed. Results: Total 205 patients were included according to the inclusion criteria of the study. Mean age (years) in the study was 53.51 ± 13.97 whereas there were 146 (71.2) male and 59 (28.8) female patients who were included in the study according to the inclusion criteria. Frequency and percentage of localized haematoma among radial and femoral artery was 02 (2.1) and 06 (5.6) respectively and retroperitonial haematoma among radial and femoral artery was 8 (8.2) and 17 (15.7) respectively. Conclusion: The study concluded that common bleeding complications were observed more in femoral artery route then radial artery route. Future studies must be conduct at multiple setups to know the proportion of bleeding complication either in radial or femoral artery route, so that to suggest a uniform protocol for the management of patients undergoing percutaneous coronary intervention (PCI).