Peripheral Vascular Disease

Transradial versus transfemoral approach for coronary angiography and intervention in patients above 75 years of age†

  1. Stephan Achenbach MD‡,
  2. Dieter Ropers MD‡,*,
  3. Lisa Kallert MD,
  4. Nesrin Turan MD,
  5. Robert Krähner MD,
  6. Tobias Wolf MD,
  7. Christoph Garlichs MD,
  8. Frank Flachskampf MD,
  9. Werner G. Daniel MD,
  10. Josef Ludwig MD

Article first published online: 23 JUL 2008

DOI: 10.1002/ccd.21696

Issue

Catheterization and Cardiovascular Interventions

Catheterization and Cardiovascular Interventions

Volume 72, Issue 5, pages 629–635, 1 November 2008

Additional Information

How to Cite

Achenbach, S., Ropers, D., Kallert, L., Turan, N., Krähner, R., Wolf, T., Garlichs, C., Flachskampf, F., Daniel, W. G. and Ludwig, J. (2008), Transradial versus transfemoral approach for coronary angiography and intervention in patients above 75 years of age. Catheterization and Cardiovascular Interventions, 72: 629–635. doi: 10.1002/ccd.21696

Author Information

  1. Department of Cardiology, University of Erlangen-Nürnberg, Erlangen, Germany

  1. ‡

    First two authors contributed equally to this work.

*Department of Cardiology,University of Erlangen-Nürnberg, 91054 Erlangen, Germany

  1. †

    Conflict of interest: Nothing to report.

Publication History

  1. Issue published online: 23 OCT 2008
  2. Article first published online: 23 JUL 2008
  3. Accepted manuscript online: 23 JUL 2008 12:00AM EST
  4. Manuscript Accepted: 3 JUN 2008
  5. Manuscript Received: 27 MAR 2008

Funded by

  • Deutsche Stiftung für Herzforschung, Frankfurt, Germany. Grant Number: F/05/03

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Keywords:

  • coronary angiography;
  • radial artery;
  • complications;
  • coronary intervention

Abstract

Aims: The transradial (TR) approach has potentially lower complication rates than transfemoral (TF) approach coronary angiography. However, it may be technically more challenging, especially in elderly patients with alterations in vascular anatomy. We thus determined success rates, procedural data, and complication rates of TR angiography in comparison to the TF approach in elderly patients in a randomized, prospective trial. Methods and results: Four hundred consecutive patients ≥75 years with known or suspected coronary artery disease were included in the study. After exclusion of 93 patients with contraindications to the radial approach, 152 patients were randomized to the TR and 155 to TF coronary angiography and intervention. In 13 patients randomized to TR, cross-over to TF was necessary (9%). Total examination time was significantly longer for the TR approach (18.1 vs. 15.0 min, P = 0.009), but no difference was found for fluoroscopy time, number of catheters used, or amount of contrast agent. The rate of major complications (bleeding requiring surgery or transfusion, stroke) was 0% for TR and 3.2% for TF approach (P < 0.001). Minor complications occurred in 1.3% versus 5.8% of patients (P < 0.001). Conclusion: In elderly patients, TR coronary angiography and intervention has a high technical success rate and lower complication rates than the TF approach. © 2008 Wiley-Liss, Inc.

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