THE RADIAL ARTERY - AN APPLICABLE APPROACH TO COMPLEX CORONARY ANGIOPLASTY

The purpose of this study was to assess the clinical value of the tran sradial approach (TRA) in coronary angioplasty. During the 18 month pe riod from June 1994 to December 1995, 250 patients (mean age 61+/-11) underwent coronary angioplasty using the transradial approach, In 7 (2 .8%) radial puncture was unsuccessful and in 6 (2.4%) additional femor al access was needed to complete the procedure. angioplasty of two or three vessels and 49.5% had type B2 or C lesions. Sixty five patients (22%) had additional procedures: stent implantations in 50 (16%) and r otational ablation in 15 (6%). Angiographic success was 97% and there were no deaths. Major procedural complications included: Q-wave myocar dial infarction in 2 (0.8%), non-Q-wave myocardial infarction in 5 (2. 0%), urgent coronary artery bypass grafting in 2 (0.8%) and CVA in 2 ( 0.8%). Local vascular complication included: compartment syndrome nece ssitating fasciotomy in 1 patient (0.4%), mild hematoma in 6 (2.4%) an d a small pseudoaneurysm heated by local compression in 4 (1.6%). Radi al pulse was palpated in 93% before discharge and in 3% adequate now c ould be heard with Doppler. No patient suffered from ischemia of the h and. Complex coronary angioplasty can be performed safely using the TR A with few vascular complications.