BRACHIAL, RADIAL, OR FEMORAL APPROACH FOR ELECTIVE PALMAZ-SCHATZ STENT IMPLANTATION - A RANDOMIZED COMPARISON

From October 1994 to November 1995, 150 male eligible patients were ra ndomly assigned to Palmaz-Schatz stent implantation through 6 French c atheters using the femoral (puncture) (0 = 56), radial (puncture) (0 = 56), or brachial (cutdown)(n = 38) approach at 6 participating Belgia n centers. Acenocoumarol was given for 1 month after stenting. End poi nts: Primary-entry site complications (bleeding, haematoma, transfusio n, occlusion, surgery) poststent implantation. Secondary-success rate, stent thrombosis, Q or non Q wave MI, repeat PTCA, CABG, CVA, haemorr age, death. There were no statistically significant differences betwee n the three groups for base line and angiographic patient characterist ics, procedural characteristics, in hospital outcome, average hospital isation time after stenting, events during the month after stenting, o r local complications at 1 month follow-up. The only statistically sig nificant difference was the arterial time of the procedure: mean +/- S D (minutes) brachial 31.0 +/- 10.02 P < 0.001, femoral 42.2 +/- 21.8, radial 55.8 +/- 31.3 *P < 0.0001 (*brachial vs. femoral,**brachial v s. radial). There was a clear trend toward more technical difficulties and more problems with the radial approach, In each group: vascular s urgery at entry site: 0%, blood transfusion: 0%. In our study, local c omplications and length of hospital stay were similar with the three p ossible approaches, and brachial approach was associated with a shorte r arterial time. (C) 1997 Wiley-Liss, Inc.