Comparison of Vascular Complications in Patients with Percutaneous Coronary Intervention by Trans-radial and Trans-femoral Approach

  • ABM Riaz Kawsar Assistant Registrar, Department of Cardiology, National Institute of Cardiovascular Diseases, Dhaka, Bangladesh
  • Mir Jamal Uddin Professor, Department of Cardiology, National Institute of Cardiovascular Diseases, Dhaka, Bangladesh
  • Abdul Momen Associate Professor, Department of Cardiology, National Institute of Cardiovascular Diseases, Dhaka, Bangladesh
  • Tariq Ahmed Chowdhury Assistant Professor, Department of Cardiology, National Institute of Cardiovascular Diseases, Dhaka, Bangladesh
  • Kajal Kumar Karmoker Associate Professor, Department of Cardiology, National Institute of Cardiovascular Diseases, Dhaka, Bangladesh
  • Samir Kumar Kundu Associate Professor, Department of Cardiology, National Institute of Cardiovascular Diseases, Dhaka, Bangladesh
  • Md Monsurul Hoque Associate Professor, Department of Cardiology, National Institute of Cardiovascular Diseases, Dhaka, Bangladesh
  • Sharadindu Shekhar Roy Junior Consultant, Department of Cardiology, National Institute of Cardiovascular Diseases, Dhaka, Bangladesh
  • Anup Kumar Howlader Assistant Registrar, Department of Cardiology, National Institute of Cardiovascular Diseases, Dhaka, Bangladesh
  • Mohammad Abdul Matin Junior Consultant, Cardiology, Upazilla Health Complex, Parshuram, Feni, Bangladesh
Keywords: Vascular complications, TR-PCI, TF-PCI.

Abstract

Background and Objective: Trans-radial approach of coronary catheterization has been increasingly used as an alternative to transfemoral approach due to less vascular complications, earlier ambulation and improved patient comfort. The aim of the study was to compare procedural and post procedural vascular complications in patients with percutaneous coronary intervention by trans-radial and transfemoral approach.

Methods: This observational comparative study was conducted in the National Institute of Cardiovascular Diseases between June 2015 to May 2016. A total of 180 patients were categorized into two groups according to the approach of the percutaneous coronary intervention (PCI). Group I comprising 90 patients who underwent trans-radial PCI and group II consists of 90 patients who underwent transfemoral PCI. Patients with an abnormal Allen’s test, acute coronary syndrome, history of coronary artery bypass surgery, chronic renal insufficiency or older age (>75 years) were excluded.

Results: Patient demographics were the same in both groups. The mean procedural time in min (37.44±5.13 vs 34.14±4.42, p=0.004) and fluoroscopy time in min (21.62±4.11 vs 17.55±2.78, p=0.02) were more in TR-PCI group but the mean haemostasis time in min (7.58±1.11 vs 15.59±3.33, p=0.005) and ambulation time in hour (0.00±0.00 vs 15.59±3.33, p=<0.001) were more in TF-PCI group. Significant arterial spasm following puncture (6.7% vs 0%, p=0.01) were found in trans-radial group but access site bleeding during procedure (2.2% vs 8.9%, p=0.04) were more in TF-PCI group. After the procedure major hematoma (0% vs 4.4%, p=0.04), minor hematoma (5.7% vs 14.4%, p=0.04) and ecchymosis (4.4% vs 13.3%) were significant in TF-PCI group but vessel occlusion (5.7% vs 0%, p=0.02) were significant in TR-PCI group. The mean hospital stays, day (1.64±0.42 vs 2.54±0.62) were more in TF-PCI group.

Conclusion: TR-PCI is safe in respect of procedural and post procedural vascular complications. Trans-radial procedure leads to improved quality of life after the procedure and thus gives much comfort to the patient. It also shortened mean duration of hospital stay. So, trans-radial approach is an attractive alternative to conventional transfemoral approach.

Bangladesh Heart Journal 2019; 34(2) : 86-91

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Abstract
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Published
2019-12-12
How to Cite
Kawsar, A., Uddin, M., Momen, A., Chowdhury, T., Karmoker, K., Kundu, S., Hoque, M. M., Roy, S., Howlader, A., & Matin, M. A. (2019). Comparison of Vascular Complications in Patients with Percutaneous Coronary Intervention by Trans-radial and Trans-femoral Approach. Bangladesh Heart Journal, 34(2), 86-91. https://doi.org/10.3329/bhj.v34i2.44438
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Original Articles