TRANSRADIAL APPROACH FOR CORONARY ANGIOGRAPHY AND ANGIOPLASTY

The transradial approach has currently been advocated as an alternativ e catheterization method for coronary angiography and angioplasty, due to the recent miniaturization of angioplasty equipment. The purpose o f this study was to assess the practical clinical applicability of thi s method. From June to November 1994, 100 patients underwent coronary angiography and angioplasty with the transradial approach. Their mean age was 66.6 +/- 11.2 years, and 79 were men. In 4, radial puncture wa s not successful, and in 3, femoral access was necessary to complete t he procedure. Coronary angioplasty was performed in 63 patients (76 le sions) with angiographic success (per lesion) of 96%. In 5 patients, a stent was successfully implanted. All patients were ambulatory on the day after the angioplasty procedure. In 98% of the patients, the intr oducer was taken out 1 to 4 hours after the procedure by local compres sion using a special custom-made device. No patient required blood tra nsfusion. Major complications occurred in 2 patients; both had a cereb rovascular accident (1 probably not procedure-related), and both recov ered. A radial pulse was palpated in 91 of the patients before dischar ge, and in 6 others, adequate flow could be heard with Doppler. In 2 p atients, radial flow was restored within several weeks. None of the pa tients suffered from ischemia of the hand. Two patients had a small ps eudoaneurysm successfully treated by local compression. Thus, coronary angioplasty can be performed safely using the transradial approach wi th relatively few vascular complications and with better patient comfo rt. However, the procedure is more time-consuming initially compared w ith the transfemoral approach due to a learning curve regarding equipm ent selection and catheter manipulation.