Portal de Periódicos da CAPES

Transradial versus transfemoral approach for coronary angiography and intervention in patients above 75 years of age

2008; Wiley; Volume: 72; Issue: 5 Linguagem: Inglês

10.1002/ccd.21696

1522-726X

Stephan Achenbach, Dieter Ropers, Lisa Kallert, Nesrin Turan, Robert Krähner, Tobias Wolf, Christoph D. Garlichs, Frank A. Flachskampf, Werner G. Daniel, Josef Ludwig,

Acute Myocardial Infarction Research

Abstract Aims: The transradial (TR) approach has potentially lower complication rates than transfemoral (TF) approach coronary angiography. However, it may be technically more challenging, especially in elderly patients with alterations in vascular anatomy. We thus determined success rates, procedural data, and complication rates of TR angiography in comparison to the TF approach in elderly patients in a randomized, prospective trial. Methods and results: Four hundred consecutive patients ≥75 years with known or suspected coronary artery disease were included in the study. After exclusion of 93 patients with contraindications to the radial approach, 152 patients were randomized to the TR and 155 to TF coronary angiography and intervention. In 13 patients randomized to TR, cross‐over to TF was necessary (9%). Total examination time was significantly longer for the TR approach (18.1 vs. 15.0 min, P = 0.009), but no difference was found for fluoroscopy time, number of catheters used, or amount of contrast agent. The rate of major complications (bleeding requiring surgery or transfusion, stroke) was 0% for TR and 3.2% for TF approach ( P < 0.001). Minor complications occurred in 1.3% versus 5.8% of patients ( P < 0.001). Conclusion: In elderly patients, TR coronary angiography and intervention has a high technical success rate and lower complication rates than the TF approach. © 2008 Wiley‐Liss, Inc.