COMPARISON OF RADIAL VS FEMORAL APPROACH IN ELDERLY PATIENTS UNDERGOING PERCUTENEOUS CORONARY INTERVENTION

http://doi.org/10.46536/jpumhs/2023/13.01.403

Abstract

Introduction The radial access might have less complications than the femoral access.

Objective: In older individuals with changed vascular anatomy, it might potentially be more

challenging. In contrast to the femoral method, we evaluated the success rates, technical

details and complication rates of radial angiography in elderly patients. Material &

Methods: This study was conducted at the Cardiology Department Saidu Group of

Teaching hospitals between January 2019 and January 2020. In this study, we enrolled all

patients referred to our center for in-patient invasive angiography who were 65 years of age or

older and had a history of probable coronary artery disease or suspected progression of known

coronary disease. Two groups of patients were equally divided. Each group consists of 500

patients. The femoral artery was accessed by group 2 patients, while the radial artery was

accessed by group 1.Results: Major adverse cardiovascular events (MACE) observed in

group1 in 2(0.4%) cases, and in group 2 in 17(3.4%) cases, all of which were complications at

the arterial access site. Minor adverse events occurred in group2 was 29(5.8%) as opposed to

9(1.8%) in group 1.Overall duration was significantly longer in group 1 as compare to group 2

(31.1 min. vs. 23.5 min) Those in group 1 had a lower mean GRACE score (110±32 versus

128±41), improved renal function according to cretanine level (0.8±0.4 versus 1.0±0.8) and a

reduced prevalence of indications of left ventricular failure (9% versus 23%) when compared to

patients in group 2. Time of admission for the type of ACS heart rate (69±15 Vs 75±16), systolic

arterial pressure (141±30 Vs 150±32), positive troponin 59(79.7%) Vs 51(68.9%),

electrocardiographic ischemia 190(38%) Vs 179(35.8%). Conclusion: In elder patients over

the age of 65, radial coronary angiography have a greater technological success rate and

fewer complications than femoral approach.