NEW YORK (Reuters Health) – Using a transradial rather than a transfemoral approach for percutaneous coronary intervention (PCI) can reduce vascular access complications and shorten the hospital stay, according to a report in the American Heart Journal for November.

The findings stem from an analysis of data for 13,499 consecutive PCIs performed at the University Health Network Toronto between April 2000 and September 2006. Propensity scoring was used to compare the outcomes of 3198 femoral access patients with those of 3198 matched radial access patients.

Patients treated with the transradial approach had a vascular access complication rate of 0.6% compared with a 1.5% rate in the transfemoral group (p < 0.001), senior author Dr. Vladmir Dzavik, from Toronto General Hospital, and colleagues note. On multivariate analysis, use of the transradial approach cut the risk of access site complications by 61%. Conversely, primary PCI, recent MI, age (per 10 years), and female gender increased the risk by 336%, 100%, 37%, and 178%, respectively. The transradial approach was also associated with a shorter hospital length of stay than with the transfemoral route — 1.46 vs 1.54 nights, a significant difference at p < 0.001. In an accompanying editorial, Dr. Ian C. Gilchrist, from Hershey Medical Center, Pennsylvania, and Dr. John K. French, from Liverpool Hospital, Australia, comment that “given the reduction in complications and length of stay demonstrated by (Dr. Dzavik’s group), further evidence is now available to encourage changes in practice techniques that may have profound benefits to our patients.” Reference:
Am Heart J 2008;156:864-870.