Trends in the Prevalence and Outcomes of Radial and Femoral Approaches to Percutaneous Coronary Intervention. A Report From the National Cardiovascular Data Registry

Sunil V. Rao, Fang Shu Ou, Tracy Y. Wang, Matthew T. Roe, Ralph Brindis, John S. Rumsfeld, Eric D. Peterson

Research output: Contribution to journalArticle

449 Scopus citations

Abstract

Objectives: Our goal was to compare trends in the prevalence and outcomes of the radial and femoral approaches to percutaneous coronary intervention (PCI) in contemporary clinical practice. Background: There are few current data on the use and outcomes of the radial approach to PCI (r-PCI) in clinical practice. Methods: Data from 593,094 procedures in the National Cardiovascular Data Registry (606 sites; 2004 to 2007) were analyzed to evaluate trends in use and outcomes of r-PCI. Logistic regression was used to evaluate the adjusted association between r-PCI and procedural success, bleeding complications, and vascular complications. Outcomes in elderly patients, women, and patients with acute coronary syndrome were specifically examined. Results: Although the proportion of r-PCI procedures has recently increased, it only accounts for 1.32% of total procedures (n = 7,804). Compared with the femoral approach, the use of r-PCI was associated with a similar rate of procedural success (adjusted odds ratio: 1.02 [95% confidence interval: 0.93 to 1.12]) but a significantly lower risk for bleeding complications (odds ratio: 0.42 [95% confidence interval: 0.31 to 0.56]) after multivariable adjustment. The reduction in bleeding complications was more pronounced among patients <75 years old, women, and patients undergoing PCI for acute coronary syndrome. Conclusions: The use of r-PCI is rare in contemporary clinical practice, but it is associated with a rate of procedural success similar to the femoral approach and with lower rates of bleeding and vascular complications, even among high-risk groups. These results suggest that wider adoption of r-PCI in clinical practice may improve the safety of PCI.

Original languageEnglish (US)
Pages (from-to)379-386
Number of pages8
JournalJACC: Cardiovascular Interventions
Volume1
Issue number4
DOIs
StatePublished - Aug 1 2008

Keywords

  • outcomes
  • percutaneous coronary intervention
  • radial artery

ASJC Scopus subject areas

  • Cardiology and Cardiovascular Medicine

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