Comparison of Frequency of Bleeding and Major Adverse Cardiac Events After Transradial Versus Transfemoral Intervention in the Recent Antiplatelet Era

Choe, Jeong Cheon; Choi, Jong Hyun; Kim, Bo Won; Park, Jin Sup; Lee, Hye Won; Oh, Jun; Choi, Jung Hyun; Lee, Han Cheol; Hong, Taek Jong; Youn, Young Jin; Lee, Seung Hwan; Cho, Byung Ryul; Kim, Doo Il; Han, Kyoo Rok; Jeong, Myung Ho; Yoon, Junghan

doi:10.1016/j.amjcard.2016.02.033

Cited by 5 publications

(1 citation statement)

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“…Interventional cardiology progressively adopted the transradial approach for coronary angiography over the past two decades, culminating in a radial-first strategy recommended by the American Heart Association due to significantly lower bleeding and vascular complications, as well as a significant mortality benefit compared with the transfemoral approach 1–13. With robust findings of improved patient safety and increased patient satisfaction14 15 demonstrated in the cardiology literature, neuroendovascular surgeons are increasingly employing transradial access for neuroendovascular procedures 16–26.…”

Section: Introductionmentioning

confidence: 99%

Transradial versus transfemoral approaches for diagnostic cerebral angiography: a prospective, single-center, non-inferiority comparative effectiveness study

Stone

Zussman

Tonetti

et al. 2020

J NeuroIntervent Surg

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BackgroundInterventional cardiology produced level 1 evidence recommending radial artery-first for coronary angiography given lower vascular complications. Neuroendovascular surgeons have not widely adopted the transradial approach. This prospective, single center, non-inferiority comparative effectiveness study aims to compare the transradial and transfemoral approaches for diagnostic cerebral angiography with respect to efficacy, safety and patient satisfaction.MethodsConsecutive patients presenting for diagnostic cerebral angiography were selected to undergo right radial or femoral access based on date of presentation. Primary outcome was ability to answer the predefined diagnostic goal of the cerebral angiogram using the initial access site and was assessed with a non-inferiority design. Secondary outcomes included technical success per vessel, complications, procedure times and patient satisfaction.ResultsA total of 312 patients were enrolled, 158 and 154 for right radial and femoral access, respectively. The diagnostic goal of the angiogram was achieved in 152 of 154 (99%) patients who underwent attempted femoral access compared with 153 of 158 (97%) patients who underwent radial access, confirming non-inferiority of the transradial approach. Secondary outcomes showed equivalent technical success by vessel, no major complications, and similar frequency of minor complications between the two approaches. In-room time was similar between approaches, though post-procedure recovery room time was significantly shorter for transradial patients. Patient satisfaction results significantly favored the radial approach.ConclusionsIn patients undergoing diagnostic cerebral angiography, transfemoral and transradial access achieve procedural goals with similar effectiveness and safety, though patients strongly prefer the radial approach. Findings support consideration of adopting a radial-first strategy for diagnostic cerebral angiography.

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Section: Introductionmentioning

confidence: 99%