COMPARISON OF THE EFFECTIVENESS OF RADIAL VERSUS FEMORAL ACCESS FOR DIAGNOSTIC AND THERAPEUTIC PROCEDURES IN PATIENTS WITH PERIPHERAL  ARTERIAL DISEASE

B  KHAN; AT KHAN; A MUHAMMAD; S SAWAR; F RAHMAN; MU HASSAN

doi:10.54112/bcsrj.v2023i1.244

Authors

B KHAN PG Resident, Cardiology Department, Hayatabad Medical Complex, Peshawar
AT KHAN Department of Medicine Hayatabad Medical Complex, Peshawar, Pakistan
A MUHAMMAD Department of Medicine Khalifa Gulnawaz Hospital, Bannu, Pakistan
S SAWAR Department of Cardiology, Hayatabad Medical Complex, Peshawar, Pakistan
F RAHMAN Department of Radiology Hayatabad Medical Complex, Peshawar, Pakistan
MU HASSAN 1. Department of Cardiology, Hayatabad Medical Complex, Peshawar, Pakistan

DOI:

https://doi.org/10.54112/bcsrj.v2023i1.244

Keywords:

cardiology, Diagnostic procedure, Femoral Access, Radial Access

Abstract

Peripheral arterial disease (PAD) is a medical condition in which the blood vessels outside the heart and brain were affected. The study's main objective is to compare the effectiveness of radial versus femoral access for diagnostic and therapeutic procedures in patients with peripheral arterial disease. The research article aimed to compare the effectiveness of radial and femoral access for diagnostic and therapeutic procedures in patients with the peripheral arterial disease (PAD). The study was conducted in two hospitals in Peshawar, Pakistan - Hayatabad Medical Complex and Lady Reading Hospital. The study duration was from January 2020 to December 2020. A total of 384 patients were enrolled in the study, with 192 randomly assigned to the radial access group and 192 to the femoral access group. The study found that RA was associated with a significantly lower risk of major bleeding and access site complications compared to FA. Specifically, the incidence of major bleeding was 1.56% in the radial access group and 5.73% in the femoral access group (p=0.02), and the incidence of access site complications was 2.6% in the radial access group, 8.3% in the femoral access group (p=0.01). In conclusion, our study suggests that radial access is a safe and effective alternative to femoral access for diagnostic and therapeutic procedures in patients with peripheral arterial disease. Radial access is associated with lower rates of major bleeding and access site complications, particularly for diagnostic procedures, and may offer advantages such as faster patient ambulation and improved patient comfort.

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References

Achenbach, S., Ropers, D., Kallert, L., Turan, N., Krähner, R., Wolf, T., Garlichs, C., Flachskampf, F., Daniel, W. G., and Ludwig, J. (2008). Transradial versus transfemoral approach for coronary angiography and intervention in patients above 75 years of age. Catheterization and Cardiovascular Interventions 72, 629-635.

Bertrand, O. F., Rao, S. V., Pancholy, S., Jolly, S. S., Rodés-Cabau, J., Larose, É., Costerousse, O., Hamon, M., and Mann, T. (2010). Transradial approach for coronary angiography and interventions: results of the first international transradial practice survey. JACC: Cardiovascular Interventions 3, 1022-1031.

Ferrante, G., Rao, S. V., Jüni, P., Da Costa, B. R., Reimers, B., Condorelli, G., Anzuini, A., Jolly, S. S., Bertrand, O. F., and Krucoff, M. W. (2016). Radial versus femoral access for coronary interventions across the entire spectrum of patients with coronary artery disease: a meta-analysis of randomized trials. JACC: Cardiovascular Interventions 9, 1419-1434.

Kiemeneij, F., Laarman, G. J., Odekerken, D., Slagboom, T., and van der Wieken, R. (1997). A randomized comparison of percutaneous transluminal coronary angioplasty by the radial, brachial and femoral approaches: the access study. Journal of the American College of Cardiology 29, 1269-1275.

Krishnan, S. C., and Salazar, M. (2010). Septal pouch in the left atrium: a new anatomical entity with potential for embolic complications. JACC: Cardiovascular Interventions 3, 98-104.

Mason, P. J., Shah, B., Tamis-Holland, J. E., Bittl, J. A., Cohen, M. G., Safirstein, J., Drachman, D. E., Valle, J. A., Rhodes, D., and Gilchrist, I. C. (2018). An update on radial artery access and best practices for transradial coronary angiography and intervention in acute coronary syndrome: a scientific statement from the American Heart Association. Circulation: Cardiovascular Interventions 11, e000035.

Ngandu, T., Lehtisalo, J., Solomon, A., Levälahti, E., Ahtiluoto, S., Antikainen, R., Bäckman, L., Hänninen, T., Jula, A., and Laatikainen, T. (2015). A 2 year multidomain intervention of diet, exercise, cognitive training, and vascular risk monitoring versus control to prevent cognitive decline in at-risk elderly people (FINGER): a randomised controlled trial. The Lancet 385, 2255-2263.

Perri, J. L., Nolan, B. W., Goodney, P. P., DeMartino, R. R., Brooke, B. S., Arya, S., Conrad, M. F., and Cronenwett, J. L. (2017). Factors affecting operative time and outcome of carotid endarterectomy in the Vascular Quality Initiative. Journal of vascular surgery 66, 1100-1108.

Rashid, M., Kwok, C. S., Pancholy, S., Chugh, S., Kedev, S. A., Bernat, I., Ratib, K., Large, A., Fraser, D., and Nolan, J. (2016). Radial artery occlusion after transradial interventions: a systematic review and meta‐analysis. Journal of the American Heart Association 5, e002686.

Sallam, M., Al-Hadi, H., Rathinasekar, S., and Chandy, S. (2009). Comparative study of the radial and femoral artery approaches for diagnostic coronary angiography. Sultan Qaboos University Medical Journal 9, 279-286.

Scalise, R. F. M., Salito, A. M., Polimeni, A., Garcia-Ruiz, V., Virga, V., Frigione, P., Andò, G., Tumscitz, C., and Costa, F. (2019). Radial artery access for percutaneous cardiovascular interventions: contemporary insights and novel approaches. Journal of Clinical Medicine 8, 1727.

Valgimigli, M., Gagnor, A., Calabró, P., Frigoli, E., Leonardi, S., Zaro, T., Rubartelli, P., Briguori, C., Andò, G., and Repetto, A. (2015). Radial versus femoral access in patients with acute coronary syndromes undergoing invasive management: a randomised multicentre trial. The Lancet 385, 2465-2476.

Vickers, N. J. (2017). Animal communication: when i’m calling you, will you answer too? Current biology 27, R713-R715.

Wang, X., Diao, C., Yang, X., Yang, Z., Liu, M., Li, X., and Tang, H. (2016). ICP4-induced miR-101 attenuates HSV-1 replication. Scientific Reports 6, 23205.