Vascular complications and clinical outcome after coronary angioplasty with platelet IIb/IIIa receptor blockade - Comparison of transradial vs transfemoral arterial access

Aims Vascular complications associated with femoral artery access for inter ventional cardiological procedures may increase morbidity especially in pat ients receiving anticoagulants, aspirin, ticlopidine and platelet glycoprot ein IIb/IIIa receptor inhibitors. The use of radial arterial access has the potential to reduce the incidence of access site bleeding complications. T he purpose of this study was to compare outcomes after the radial and femor al approaches in patients treated with the platelet IIb/IIIa inhibitor, abc iximab. Methods and Results One hundred and fifty consecutive patients treated by a bciximab underwent angioplasty by the radial or femoral approach in 83 and 67 cases, respectively. Outcome variables were major cardiac events and maj or access site bleeding at 1-month follow-up. Freedom from major cardiac ev ents at 1-month follow-up occurred in 78 (93.9%) and 63 (94.0%) patients in the radial and femoral groups, respectively (P=0.99). There were no major access site bleeding complications in the radial group, as opposed to five (7.4%) in the femoral group, r=0.04. Postprocedure length of stay, days (3. 7 +/- 6.0 radial vs 3.7 +/- 2.6 femoral, P=0.96) as well as total hospital length of stay (5.0 +/- 3.3 radial vs 4.9 +/- 3.0 femoral, P=0.72) were sim ilar in both groups. Conclusion Coronary angioplasty in patients treated by abciximab using the transradial approach is efficacious with fewer major access site complicati ons than with the transfemoral approach. (Eur Heart J 2000; 21: 662-667) (C ) 2000 The European Society of Cardiology.