A Comparative Matched Analysis of Clinical Outcomes between Transradial versus Transfemoral Percutaneous Coronary Intervention

Isr Med Assoc J. 2015 Jun;17(6):360-4.

Abstract

Background: Several trials support the transradial route of percutaneous coronary intervention (PCI) since it reduces access-site vascular complications and bleeding.

Objectives: To examine the effects of transradial interventions (TRI) on clinical outcomes in a 'real-world' cohort of patients undergoing PCI.

Methods: We analyzed 4873 consecutive patients who underwent PCI at a tertiary center and identified 373 patients who underwent TRI. Patients (radial vs. femoral) were compared using a propensity score analysis to best match between groups. Outcome parameters included total mortality, myocardial infarction (MI), repeat target vessel revascularization (TVR) rates, length of hospitalization and AHt/Hb/creatinine values during hospitalization. These were evaluated at 6 months and 1 to 3 years after PCI.

Results: The rates of major adverse cardiovascular event (MACE) and its constituents were similar in the transradial vs. transfemoral groups at all time intervals: 6.7% vs. 5.5% at 6 months, 10.3% vs. 10% at 1 year, 15.7% vs. 15% at 2 years, 15.7% vs. 16% at 3 years, respectively (P = 0.6). The length of hospitalization was shorter in the TRI group (2.87 days ± 2.04 vs. 3.3 days ± 3.12, P = 0.023). We did not find significant differences between the groups in the mean AHt/Hb/creatinine values during the hospitalization course.

Conclusions: In a real-world setting of PCI, the TRI route of PCI is as safe and efficient as the femoral approach. TRI is associated with shorter duration of hospitalization.

Publication types

  • Comparative Study

MeSH terms

  • Aged
  • Female
  • Femoral Artery / surgery*
  • Follow-Up Studies
  • Hospitalization / statistics & numerical data
  • Humans
  • Length of Stay
  • Male
  • Middle Aged
  • Myocardial Infarction / epidemiology*
  • Percutaneous Coronary Intervention / adverse effects
  • Percutaneous Coronary Intervention / methods*
  • Prospective Studies
  • Radial Artery / surgery*
  • Time Factors
  • Treatment Outcome