¹Dr. Bakht Umar Khan, ²Dr. Muhammad Bilal, ³Dr. Waqas Ahmed, ⁴Dr. Rizwan Ali, ⁵Dr. Saqab Saboor

¹Fellow interventional cardiology, Armed Forces Institute of Cardiology and National Institute of Heart Diseases, Rawalpindi.
²Armed Forces institute of Cardiology, National institute of Heart Diseases, Rawalpindi
³Fellow Interventional Cardiology, Armed Forces Institute of Cardiology and National Institute Heart Diseases, Rawalpindi.
⁴Armed Forces institute of Cardiology, National institute of Heart Diseases, Rawalpindi
⁵Frontier Medical and Dental College.

CORRESPONDING AUTHOR:
Dr. Zeeshan Admad
Armed Forces Institute of Cardiology and National Heart Diseases

ABSTRACT:

Background: PCI had been extensively implemented as a minimally invasive method of revascularizing the coronary artery as a procedure to treat coronary artery disease. The vascular access route was a significant factor that defined the procedure safety and efficacy. Historically, the access site was the transfemoral approach (TFA), but a new access site (transradial approach [TRA]) was introduced because of its possible benefits such as less bleeding, earlier movement of patients and more comfortable experience. Although these advantages exist, the differences in the success rates and complications of the two methods of procedures deserved to be taken into more consideration particularly in the tertiary care systems.

Aim: This study was meant to compare the clinical outcomes, the nature of the procedure, and the rates of complications associated with the use of percutaneous coronary intervention using transradial or transfemoral intervention methods in a tertiary care facility.

Methods: It was a comparative study that was to be conducted at the Armed Forces Institute of Cardiology/National Institute of Heart Diseases (AFIC/NIHD) between September 2023 and February 2024. There were 90 patients who underwent PCI and were split into two groups, Group A (n=45) had to undergo PCI through the transradial approach and Group B (n=45) had to undergo PCI through the transfemoral approach. Demographic variables, procedure length, contrast volume, vascular complications, bleeding, and hospital stay were data collected. The SPSS software was used to statistically analyze the data, and the p-values below 0.05 were taken as significant.

Results: The average time of practice was a bit longer in transradial cohort (48.63287 minutes) than transfemoral cohort (44.215 minutes) with no significant difference between the two groups (p = 0.07). Nevertheless, the rates of complications occurring at the vascular access site in the transradial group (4.4) were low in contrast to transfemoral group (17.8) (p = 0.02). There were major bleeding events in 2.2% of the transradial and 11.1% of transfemoral (p = 0.04). The mean number of days those patients stay in the hospital was less in the transradial group (1.3 ± 0.5 days) than in the transfemoral group (2.6 ± 0.7 days) (p < 0.01). Success rates of the two approaches were similar in terms of the procedure.

Conclusion: This paper concluded that transradial method of PCI had less vascular complication, less risk of bleeding and reduced hospitalization than transfemoral one without any impairments on the success of the procedure. As such, transradial route may be regarded as a safer and more patient friendly procedure of coronary intervention in tertiary care centers.

Keywords: Percutaneous coronary intervention, transradial approach, transfemoral approach, vascular complications, bleeding risk, hospital stay, coronary artery disease.