|New study heralds radial approach to PCI. Source: TopNews Health|
While a radial approach to PCI (r-PCI) is rare in clinical practice, it is associated with a procedural success rate similar to the femoral approach and has lower rates of bleeding and vascular complications, even among high-risk groups, according to a study in the August issue of the Journal of the American College of Cardiology: Cardiovascular Interventions.
Sunil V. Rao, MD, from the Duke Clinical Research Institute in Durham, N.C., and colleagues set out to compare trends in the prevalence and outcomes of the radial and femoral approaches to PCI in contemporary clinical practice.
The researchers analyzed data from 593,094 procedures in the National Cardiovascular Data Registry (606 sites; 2004 to 2007) to evaluate trends in use and outcomes of r-PCI. They used logistic regression to evaluate the adjusted association between r-PCI and procedural success, bleeding complications and vascular complications.
The investigators said they specifically examined outcomes in elderly patients, women and patients with acute coronary syndrome (ACS).
Although the proportion of r-PCI procedures has recently increased, the authors wrote that it only accounts for 1.32 percent of total procedures (7,804).
Compared with the femoral approach, Rao and colleagues found that the use of r-PCI was associated with a similar rate of procedural success, but a significantly lower risk for bleeding complications after multivariable adjustment. The reduction in bleeding complications was more pronounced among patients <75 years old, women and patients undergoing PCI for ACS, according to the authors.
The researchers recommended that the results suggest that wider adoption of r-PCI in clinical practice may improve the safety of PCI.