Transradial access compared with femoral puncture closure devices in percutaneous coronary procedures

Alessandro Sciahbasi, Dionigi Fischetti, Amedeo Picciolo, Roberto Patrizi, Isabella Sperduti, Giuseppe Colonna, Francesco Summaria, Antonio Montinaro, Ernesto Lioy

Research output: Contribution to journalArticle

Abstract

Background: Transradial access (RA) is associated with less complications and is preferred by patients. Vascular closure devices (VCDs) may improve discomfort and may reduce complications associated with transfemoral access. Aim was to evaluate complications and discomfort associated with percutaneous coronary procedures employing RA or VCDs. Methods: We enrolled 1492 consecutive patients who underwent percutaneous coronary procedures with RA (604 procedures), femoral approach with manual compression (MC) (276 procedures), or with either Angioseal™ (311 procedures) or Starclose™ (301 procedures) closure device. Discomfort was assessed using procedure-specific questions. Major vascular complications were evaluated during hospitalization. Results: RA significantly reduced major complications (0.7%) compared to either the MC (2.9%, p = 0.03) or the VCDs (Starclose™ 2.7%, Angioseal™ 3.9%, p = 0.003). There were no significant differences in major complications between MC and either the Angioseal™ or the Starclose™. At multivariate analysis the RA was predictor of reduced complications (OR 0.26, 95% CI 0.08-0.85, p = 0.03 vs MC, and OR 0.19, 95% CI 0.07-0.57, p = 0.003 vs VCDs). The RA was associated with a significant reduction in procedural discomfort with 44.2% of patients referring no discomfort (p <0.0001). Starclose™ and Angioseal™ were better tolerated than MC (27.8%, 29.3% and 8.9% patients respectively without discomfort, p <0.0001). Conclusions: RA is associated with a significant reduction in major vascular complications compared to femoral approach even if two different VCDs are employed. VCDs are better tolerated than MC but the RA was associated with the lowest discomfort.

Original languageEnglish
Pages (from-to)199-205
Number of pages7
JournalInternational Journal of Cardiology
Volume137
Issue number3
DOIs
Publication statusPublished - Nov 2009

Keywords

  • Angioseal
  • Radial
  • Starclose
  • Vascular closure device

ASJC Scopus subject areas

  • Cardiology and Cardiovascular Medicine

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    Sciahbasi, A., Fischetti, D., Picciolo, A., Patrizi, R., Sperduti, I., Colonna, G., Summaria, F., Montinaro, A., & Lioy, E. (2009). Transradial access compared with femoral puncture closure devices in percutaneous coronary procedures. International Journal of Cardiology, 137(3), 199-205. https://doi.org/10.1016/j.ijcard.2008.06.045