Clinical comparative study of transradial versus transfemoral approach for coronary angiography and percutaneous coronary intervention in senile patients

LIU Li-xin; BI Lei; CUI Zhen-shuang; SHI Bing; WU Yun-tao; DONG Lan

doi:10.3969/j.issn.1674-4055.2016.07.19

Abstract：Objective To explore the effectivity and safety of coronary angiography and percutaneous coronary intervention (PCI) through radial artery and femoral artery in senile patients.Methods 246 cases over 80 years old were divided into a radial artery group (n=130) and a femoral artery group (n=116) according to the interventional approach. The success rate of the PCI, general conditions of the intervention, perioperative vascular complications and adverse situation, major adverse cardiovascular event (MACE) at 1 year in both groups were evaluated. Results The success rate of PCI between two groups had no significant difference (88.5%vs. 92.7%,P>0.05), so as with the incidence of MACE at 1 year (2.7%vs. 3.6%,P>0.05). The transradial approach had a higher conversion rate compared with the transfemoral approach (6.2%vs. 0%,P<0.01). Time of arterial puncture was longer with the radial versus femoral approach, while in-bed time was shorter with the radial approach (P<0.01). The incidence of vascular complications in the femoral artery group was significantly higher than that in the radial artery group (18.1%vs. 6.2%,P<0.01), such as vasovagal reaction, vesicular skin injuries, bleeding/haematomas from the puncture site had significant difference (P<0.05). The incidence of postoperatve adverse situation in the femoral artery group was significantly higher than that in the radial artery group, including abdominal distension, dysuresia, indwelling urethral catheter, lumbago and back pain, insomnia, post-operative limb pain and constipation (P<0.05). Conclusion The transradial approach for coronary angiography and percutaneous coronary intervention in senile patients has a similar clinical effect compared with the transfemoral approach, but with less vascular complications and postoperatve adverse situation.