Background: Percutaneous coronary intervention (PCI) through transradial approach (TRA) has shown to be safe and effective as transfemoral approach (TFA) among unselected patients. However, very few studies have compared the outcomes between TRA and TFA specifically in patients with a history of coronary artery bypass grafting surgery (CABG).
Methods: A total of 404 post-CABG patients who had undergone angiography or PCI were included in the study. The primary endpoint was defined as angiographic success and procedure success. The secondary endpoint was defined as in-hospital net adverse clinical events (NACEs), which included all cause of death, myocardial infarction (MI), stroke, repeat revascularization, and major bleeding. Patients were followed-up for 1-year. Major adverse cardiovascular events (MACEs), which included death, MI, and repeat revascularization, at 1-year follow-up were also compared.
Results: The angiographic success was reached by 97.4% in the TRA group compared with 100% in the TFA group (P = 0.02). The procedure success was achieved in 99.1% in the TRA group and 97.9% in the TFA group (P = 0.68). The incidence rates of in-hospital NACE (2.7% vs. 2.7%, P = 1.00) and 1-year MACE (11.5% vs. 12.0%, P = 0.88) were similar between TRA and TFA. Meanwhile, TRA was associated with a lower rate of Bleeding Academic Research Consortium ≥2 bleeding (P = 0.02). In patients undergoing graft PCI, the procedure success was similar between TRA and TFA (100.0% vs. 98.7%, P = 1.00). The procedure time (25.0 min vs. 27.5 min, P = 0.53) was also similar. No significant difference was detected between TRA and TFA in terms of in-hospital NACE (0 vs. 0, P = 1.00) and 1-year MACE (21.4% vs. 10.3%, P = 0.19).
Conclusions: Compared with TFA, TRA had lower angiographic success but had a similar procedure success in post-CABG patients. TRA was also associated with decreased bleeding and shortened hospital stay.
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http://dx.doi.org/10.4103/0366-6999.152488 | DOI Listing |
Indian Heart J
January 2025
Department of Cardiology, Sri Jayadeva Institute of Cardiovascular Sciences and Research, Bangalore, India.
Background: Cardiac catheterization via the trans-radial approach (TRA) has shown several advantages over the trans-femoral approach (TFA) but with a concern of higher radiation exposure. Considering the growing experience with TRA, this study compares patient's radiation during coronary angiography using TRA versus TFA.
Methods: This study included consecutive patients undergoing coronary angiogram over a year at tertiary hospital performed by experienced operators through radial or femoral access.
Turk Neurosurg
June 2024
Faculty of Medicine, Federal University of Rio de Janeiro.
Introduction In the realm of Carotid Artery Stenting (CAS), various access methods such as Transfemoral access (TFA), Transradial Artery access (TRA), and Transbrachial access (TBA) have been employed. While TFA is widely established, TRA and TBA offer alternative options. TBA lacks comprehensive studies, and there is a notable lack of comprehensive evidence systematically evaluating its outcomes.
View Article and Find Full Text PDFAJNR Am J Neuroradiol
December 2024
From the Department of Neurosurgery, Bucheon St. Mary's Hospital, College of Medicine, The Catholic University of Korea, Seoul, Republic of Korea.
Background And Purpose: Transradial access (TRA) for cerebral angiography has become more popular due to fewer complications and greater patient comfort compared to transfemoral access. However, the frequency and nature of neurologic complications linked to TRA remain unclear. This study aimed to determine the incidence of symptomatic neurologic complications after transradial cerebral angiography, identify risk factors, and characterize clinical and imaging features of these complications.
View Article and Find Full Text PDFPediatr Int
December 2024
Department of Pediatrics, Kurume University School of Medicine, Kurume, Fukuoka, Japan.
Background: Transradial access (TRA) is not a common vascular access in children. We have been performing TRA actively to reduce puncture complications, and the purpose of this study was to investigate the safety and efficacy of TRA in young children.
Methods: The study included 29 patients aged 5-12 years who underwent diagnostic catheterization at Kurume University Hospital.
J Clin Med
December 2024
Department of Neurosurgery, Myodani Hospital, Kobe 655-0852 Hyogo, Japan.
Carotid artery stenting (CAS) has traditionally been performed using the transfemoral approach (TFA). Recently, the transradial approach (TRA) has gained attention for its lower invasiveness and reduced complication risk. This study compares outcomes between two access strategy timeframes, TFA-first and TRA-first, to evaluate how this shift influences outcomes in a real-world setting.
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