Key result
Transradial access fails to reduce procedural failure vs transfemoral but is linked to increased radiation.
Why the study?
Coronary angiography is traditionally performed through transfemoral access, and while transradial access is increasingly used, its safety and efficacy in Bangladesh was less well studied.
Does transradial access improve safety and efficacy compared to transfemoral access in patients undergoing elective coronary angiography?
Cross-Sectional (n=100)
Randomly selected
No
Does transradial access improve safety and efficacy compared to transfemoral access in patients undergoing elective coronary angiography?
Absolute Event Rate: 8% vs 2%
p-value: p=0.169
Transradial access for coronary angiography is a safe alternative to transfemoral access, offering significantly fewer access site complications at the cost of increased fluoroscopy time and radiation dose.
Transradial access may be feasible for elective angiography; leaves open whether radiation differences warrant practice change pending randomized data.
Introduction: Coronary angiography is traditionally performed through transfemoral access. Transradial access is increasingly being used for this purpose for its various advantages. However, its use in Bangladesh is less well studied. The aim of this study was to find out the safety and efficacy of transradial access as compared to transfemoral access. Methods: This was a single-center, cross-sectional study. 100 randomly selected elective coronary angiography from August 2017 to September 2018 by the same operator using either transradial access or transfemoral access were analyzed. Results: Among 100 coronary angiography, transradial access were 50 and transfemoral access were 50. Fluoroscopy time was 3.08[1-9] vs 1.47 [1-17] minutes (p=.014), dose area product was 4807 [1947-11489] vs 3202 [1130-12826] ìGy.m2 (P<0.001), total dose was 788 [276-2055] vs 520 [158-2424] mGy (p<0.001). Transradial failure occurred in 4 (8%) cases. Transfemoral failure occurred in 1 (2%) case. There was no significant difference in failure rate between the groups (p= 0.169). Ecchymosis was the commonest (10% in transradial access vs 22% in transfemoral access, p= 0.102) among post procedure complications. Other complications like thrombophlebitis (6% vs 18%, p=0.004); hematoma (0% vs 12%, p= 0.005); puncture site bleed (2% vs 4%, p= 0. 039) were seen in TRA and transfemoral access, respectively. Conclusion: Access site complications are more in transfemoral access. Transradial access is an effective alternative to transfemoral access, and it can be performed safely by experienced operators. J Bangladesh Coll Phys Surg 2022; 40: 93-98
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Alam et al. (2022) conducted a cross-sectional in Coronary artery disease (n=100). Transradial access vs. Transfemoral access was evaluated on Procedural failure (p=0.169). Transradial access for coronary angiography showed no significant difference in procedural failure compared to transfemoral access (8% vs 2%, p=0.169), though it was associated with longer fluoroscopy times and higher radiation exposure.
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