Abstract 15750: Lower Transfusion Rate Following Percutaneous Coronary Intervention via the Radial Approach: A Four-Year, Single-Center Experience
Introduction: Prior investigators have demonstrated the substantial, negative effect of bleeding following percutaneous coronary intervention (PCI). The transradial approach for PCI significantly decreases access site bleeding compared to the femoral approach.
Hypothesis: We assessed the hypothesis that transfusion rate--as a marker for significant bleeding--would be lower using the radial as opposed to the femoral approach for PCI.
Methods: Retrospectively reviewing all PCI procedures at our institution performed between January 2006 and February 2010, we compared transfusion rates by access site and procedure indication, and explored etiologies of bleeding.
Results: Overall, there were 5255 PCI cases during the study period, 1038 via the radial approach, 4217 via femoral. The overall transfusion rate was significantly lower in the radial group, 2.1% vs. 6.2% (p<0.0001). This difference was apparent across all subgroups: elective cases (0.2% radial vs. 3.9% femoral, p<0.0001), unstable angina/NSTEMI (1.8% vs. 8.1%, p<0.0001), and non-CABG-related transfusions in STEMI cases (5.2% vs. 10.4%, p=0.03). Transfusions following radial access resulted from subsequent mechanical support (e.g., intra-aortic balloon pump), bypass surgery, gastrointestinal bleeding, rectus sheath bleeding, excess phlebotomy, and baseline anemia.
Conclusions: A transradial approach for PCI is associated with a significantly lower transfusion rate following elective and emergent procedures. Since access site selection plays an important role in minimizing bleeding, these findings have implications for decreasing morbidity in PCI, and argue for increased utilization of the radial approach.
- © 2010 by American Heart Association, Inc.