Abstract 14865: Comparative Analysis of Radial Versus Femoral Diagnostic Cardiac Catheterization Procedures in a Cardiology Training Program
Background: The use of radial access for cardiac catheterization has been increasing for both diagnostic coronary angiography and percutaneous coronary interventions. In comparison with femoral access, radial approach decreases access site complications and prolonged bed rest, which leads to patient preference. Comparison between these two techniques however, is limited with cardiology fellowship trainees as primary operators.
Methods: We conducted a retrospective study of 163 consecutive radial and 180 consecutive femoral access diagnostic cardiac catheterization procedures, with cardiology fellowship trainees as primary operators. Variables including procedure time, fluoroscopy time, dose area product (DAP), and contrast volume used were recorded for all procedures. Mann-Whitney and rank Anova tests were used for statistical analysis.
Results: The radial approach was associated with significantly higher fluoroscopy time (8.0±6.97 vs 4.25±3.01 minutes, p<0.001), DAP (10775±6724 vs 7952±4236 micoGy/m2, p<0.001), procedure time (38.31±12.25 versus 27±17.56 minutes, p<0.001), procedure start to vascular access time (8.24±6.31 versus 5.31±4.59 minutes, p<0.001), and vascular access to procedure end time (30±15.34 versus 21.2±9.57 minutes, p<0.001). These differences persisted after adjusting for patients with bypass grafts and additional imaging (p<0.001). The use of contrast amount was not significantly different between two groups (p=0.115).
Procedure start to vascular access time improved significantly with fellowship training year in both the radial (9.57±6.96 vs 8.23±6.08 vs 5.57±4.82 minutes) and femoral groups (6.17±5.07 vs 5.47±4.75 vs 4.01±3.31 minutes). Fluoroscopy time showed significant difference only in femoral access group (p<0.07). DAP did not improve with training in either access group.
Conclusion: Radial procedures were associated with more radiation dose and procedure time. Despite decrease in total procedural time for radial cases with the level of training, total radiation dose did not decrease.
Author Disclosures: G. Singh: None. E.P. Campos: None. C.J. Kavinsky: None. R.J. Snell: None. G.L. Schaer: None. N. Jolly: None.
- © 2015 by American Heart Association, Inc.