A Comparative Matched Analysis of Clinical Outcomes between Transradial versus Transfemoral Percutaneous Coronary Intervention

作者：Greenberg Gabriel^*; Bental Tamir; Lev Eli I; Assali Abid; Vaknin Assa Hanna; Kornowski Ran

来源：Israel Medical Association Journal, 2015, 17(6): 360-364.

• trans-radial intervention (TRI)
• transfemoral intervention (TFI)
• percutaneous coronary intervention (PCI)
• major adverse cardiovascular events (MACE)

Background: Several trials support the transradial route of percutaneous coronary intervention (PCI) since it reduces access-site vascular complitations and bleeding.
Objectives: To examine the effects of transradial interventions (TRI) on clinical outcomes in a 'real-world' cohort of patients undergoing PCI.
Methods: We analyzed 4873 consecutive patients who underwent PCI at a tertiary center and identified 373 patients who underwent TRI. Patients (radial vs. femoral) were compared using a propensity score analysis to best match between groups. Outcome parameters included total mortality; myocardial infarction (MI), repeat target vessel revascularization (TVR) rates, length of hospitalization and Delta Ht/Hb/creatinine values during hospitalization. These were evaluated at 6 months and 1 to 3 years after PCI.
Results: The rates of major adverse cardiovascular event (MACE) and its constituents were similar in the transradial vs. transfemoral groups at all time intervals: 6.7% vs. 5.5% at 6 months, 10.3% vs. 10% at 1 year, 15.7% vs. 15% at 2 years, 15.7% vs. 16% at 3 years, respectively (P = 0.6). The length of hospitalization was shorter in the TRI group (2.87 days +/- 2.04 vs. 3.3 days +/- 3.12, P = 0.023). We did not find significant differences between the groups in the mean Delta Ht/Hb/creatinine values during the hospitalization course:
Conclusions: In a real-world setting of PCI, the TRI route of PCI is as safe and efficient as the femoral approach. TRI is associated with shorter duration of hospitalization.

• 出版日期2015-6