Comparative Study On Trans-radial Vs Trans-femoral Approach For Primary Percutaneous Coronary Intervertion

BackgroudThe percutaneous coronary intervention (PCI) therapy can be used to rebuild coronary blood flow, relieve the ischemic myocardium. The access of PCI traditionally is through femoral artery, More complications such as hemorrhage puzzled the cardiologist. The PCI procedure through radial artery was suggested as an effective and safe method, which would make the complication lower, reduce the pain, also reduce the duration of hospitalisation. For this reason, in recent years, more and more medical centers are adopting the transradial artery approach for PCI as a routine. The aim of this study was to compare the results and complications of approach through radial or femoral artery access for PCI, also to investigate the the feasibility,safety of transradial atery access for primary PCI in patients with coronary heart diseaseMethods90 patients were randomly divided into trans-radial group of 46 cases and trans-femoral group of 44 cases. All patients underwent diagnostic coronary angiography (CAG) in order to be decided whether they need PCI or not. The access time to place the sheath, procedural time, fluoroscopy time, procedural success rates, hemostasis time and complications were compared respectively. ResultsOne case in A group was switched to trans-femoral approach because of the failure of trans-radial access. 32 cases (71.1%) in trans-radial group and 30 cases (68.2%) in trans-femoral group underwent PCI. There were no significant differences in the procedural time, fluoroscopy time and procedural success rates of CAG and PCI in both groups (52.3±24.8min vs 48.7±26.2min, 15.6±5.2min vs 13.9±6.8min, 93.8% vs 96.3%, all P>0.05). The access time in trans-radial group was longer than that in trans-femoral group(2.5±0.6 min vs 1.3±0.4min P<0.05 ) . The hemostasis time in trans-radial group was shorter than that in trans-femoral group ( 1.1±0.2min vs 20.3±2.4min P<0.01 ) . The vascular complications in trans-radial group were significantly lower than those in trans-femoral group (18.2% vs 4.4% P<0.05) ConclusionThe duration and effect by trans-radial PCI are similar to those by tran-femoral PCI. The advantages of trans-radial PCI are the lower complications, the shorter hemostasis time and better patient's comfort. Trans-radial approach for PCI is a safe and effective approach.