The Trans-radial Approach for Diagnostic Coronary Angiography and Interventions. Our Experience at Queen Alia Heart Institute / Amman - Jordan

摘要

The aim of our study was to assess our experience of coronary angiography and intervention via the radial artery in comparison to the standard approach from the femoral artery at Queen Alia Heart Institute. Method; This was a prospective study conducted from September 2010 till August 2013. This was a single operator experience. All adult patients undergoing coronary angiography or intervention were enrolled into this study. It was left to the operator's discretion to decide which patient is for trans- radial access. Demographic data, risk factors for coronary artery disease (CAD), the amount of contrast used, fluoroscopy time, and the diagnosis were collected. We also looked at the time taken for mobilization of patients following procedure, the incidence of pain from the site, any local complications and hospital stay. The data was compared to a similar number of patients who had coronary angiography via the femoral artery. Results ; We looked at 456 patients. There were 346 males (76%) and 110 females (24%). Their age ranged from 29 - 76 years with a mean of 53.5 (± 10.5) years. The right radial artery was used in almost all cases (454 patients, and the left radial in 2 patients). The prevalence of diabetes was 48.5%, hypertension 59.2%, family history of premature CAD 28%, hyperlipidaemia in 30% and 44% were smokers. These figures were the same for patients who had the procedure via the trans- femoral artery done during the study period. Successful angiography was feasible in 449 patients (98.46%). Diagnostic angiography was done in 319 patients (71%), while coronary intervention was done in 130 patients (29%). Total procedural time averaged 41 (± SD = 22) minutes for trans-radial compared to 40 (± 23) for trans- femoral approach (P non significant). Fluoroscopy time was 15 (± 10) minutes for the former compared to 18 (± 13) minutes for the later approach (P non significant). The amount of contrast used was 180 (± 64) ml for trans-radial compared to 192 (± 73 ml) for the trans-femoral approach (P non-significant). On average patients in the trans-radial group had less access site complications with early mobility and earlier discharge. Conclusion; Coronary angiography and intervention via the radial artery has a high success rate with no difference in terms of procedure time, amount of contrast or fluoroscopy time. It has demonstrable advantages in terms of local site complications, early mobility and discharge leading to better patient's satisfaction