Instead of threading catheters from the femoral artery in the groin, cardiologists can safely use the radial artery in the arm to gain access to coronary arteries for angioplasty, stent placement, and other procedures, according to a new meta-analysis in the July 21, 2004 issue of the Journal of the American College of Cardiology.
“Overall, the radial approach is safe and reduces local complications, and if done by an expert, is almost always feasible. It is useful for cardiologists to learn the radial approach in addition to the femoral approach, so they have the opportunity to choose the right one in every patient, and in order to predict possible complications and avoid them,” said Pierfrancesco Agostoni, MD at the University of Verona in Italy.
The work was done in cooperation with colleagues at Catholic University in Rome; Piemonte Orientale University in Novara, Italy; Institut Hospitalier Jacques Cartier – ICPS in Massy, France; and Centre Hospitalier Universitaire in Caen, France.
Threading a catheter through arteries from the arm to the heart is considered more challenging because there are more turns than in the relatively straight route from the groin. Some catheter devices won’t fit through the radial artery. However, studies have generally seen fewer local complications, including bleeding, and quicker recovery among patients who had a transradial procedure.
Sorting out the pros and cons of each approach has been difficult.
“Several randomized trials have been undertaken to compare the transradial and transfemoral approach, but the majority of them carefully selected a small number of homogeneous patients, were underpowered to detect differences in major adverse events, and yielded somewhat conflicting and inconclusive results,” the authors wrote.