PMID- 19926042
OWN - NLM
STAT- MEDLINE
DCOM- 20100127
LR  - 20220409
IS  - 1876-7605 (Electronic)
IS  - 1936-8798 (Linking)
VI  - 2
IP  - 11
DP  - 2009 Nov
TI  - A randomized comparison of transradial versus transfemoral approach for coronary 
      angiography and angioplasty.
PG  - 1047-54
LID - 10.1016/j.jcin.2009.07.016 [doi]
AB  - OBJECTIVES: The aim of the study was to evaluate the safety, feasibility, and 
      procedural variables by the transradial approach compared with the transfemoral 
      access in a standard population of patients undergoing coronary catheterization. 
      BACKGROUND: Coronary catheterization is usually performed via the transfemoral 
      approach. Transradial access may offer some advantages in comparison with 
      transfemoral access especially under conditions of aggressive anticoagulation and 
      antiplatelet treatment. METHODS: Between July 2006 and January 2008, a total of 
      1,024 patients undergoing coronary catheterization were randomly assigned to the 
      transradial or transfemoral approach. Patients with an abnormal Allen's test, 
      history of coronary artery bypass surgery, simultaneous right heart 
      catheterization, chronic renal insufficiency, or known difficulties with the 
      radial or femoral access were excluded. RESULTS: Successful catheterization was 
      achieved in 494 of 512 patients (96.5%) in the transradial and in 511 of 512 
      patients (99.8%) in the transfemoral group (p < 0.0001). Median procedural 
      duration (37.0 min, interquartile range [IQR] 19.6 to 49.1 min vs. 40.2 min, IQR 
      24.3 to 50.8 min; p = 0.046) and median dose area product (38.2 Gycm(2), IQR 20.4 
      to 48.5 Gycm(2) vs. 41.9 Gycm(2), IQR 22.6 to 52.2 Gycm(2); p = 0.034) were 
      significantly lower in the transfemoral group compared with the transradial 
      access group. A median amount of contrast agent was similar among both groups. 
      Vascular access site complications were higher in the transfemoral group (3.71%) 
      than in the transradial group (0.58%; p = 0.0008) CONCLUSIONS: The findings of 
      the present study show that transradial coronary angiography and angioplasty are 
      safe, feasible, and effective with similar results to those of the transfemoral 
      approach. However, procedural duration and radiation exposure are higher using 
      the transradial access. In contrast to the transfemoral route, the rate of major 
      vascular complications was negligible using the transradial approach.
FAU - Brueck, Martin
AU  - Brueck M
AD  - Department of Cardiology, Clinic of Wetzlar, Wetzlar, Germany. 
      Martin.Brueck@hkw.med.uni-giessen.de
FAU - Bandorski, Dirk
AU  - Bandorski D
FAU - Kramer, Wilfried
AU  - Kramer W
FAU - Wieczorek, Marcus
AU  - Wieczorek M
FAU - Holtgen, Reinhard
AU  - Holtgen R
FAU - Tillmanns, Harald
AU  - Tillmanns H
LA  - eng
PT  - Comment
PT  - Comparative Study
PT  - Journal Article
PT  - Randomized Controlled Trial
PL  - United States
TA  - JACC Cardiovasc Interv
JT  - JACC. Cardiovascular interventions
JID - 101467004
RN  - 0 (Anticoagulants)
RN  - 0 (Platelet Aggregation Inhibitors)
SB  - IM
CON - JACC Cardiovasc Interv. 2009 Nov;2(11):1055-6. doi: 10.1016/j.jcin.2009.08.017. 
      PMID: 19926043
CIN - JACC Cardiovasc Interv. 2010 Apr;3(4):463; author reply 463-4. doi: 
      10.1016/j.jcin.2010.01.013. PMID: 20398879
MH  - Aged
MH  - Angioplasty, Balloon, Coronary/adverse effects/*methods
MH  - Anticoagulants/therapeutic use
MH  - Cardiac Catheterization/adverse effects/*methods
MH  - Coronary Angiography/adverse effects/*methods
MH  - Coronary Artery Disease/*diagnostic imaging/*therapy
MH  - Feasibility Studies
MH  - Female
MH  - *Femoral Artery
MH  - Humans
MH  - Male
MH  - Middle Aged
MH  - Platelet Aggregation Inhibitors/therapeutic use
MH  - Prospective Studies
MH  - *Radial Artery
MH  - Radiography, Interventional
MH  - Time Factors
MH  - Treatment Outcome
EDAT- 2009/11/21 06:00
MHDA- 2010/01/28 06:00
CRDT- 2009/11/21 06:00
PHST- 2009/07/13 00:00 [received]
PHST- 2009/07/25 00:00 [accepted]
PHST- 2009/11/21 06:00 [entrez]
PHST- 2009/11/21 06:00 [pubmed]
PHST- 2010/01/28 06:00 [medline]
AID - S1936-8798(09)00584-6 [pii]
AID - 10.1016/j.jcin.2009.07.016 [doi]
PST - ppublish
SO  - JACC Cardiovasc Interv. 2009 Nov;2(11):1047-54. doi: 10.1016/j.jcin.2009.07.016.