WRIST OR GROIN SAFETY, COMPLICATIONS AND PREDICTORS. FEMORAL VS TRANS RADIAL CORONARY ANGIOGRAPHY

BACKGROUND: Coronary angiography is a lifesaving procedure but not immune to complication. Complication rate fall dramatically in the last decade but still mild to severe complication pop up globally. The route of angiography, operator experience, selection of patient, tool and hardware of angiography are main predictors of complication. We conducted a study at our center to evaluate the incidence and difference of complication of angiography from radial and femoral route.

OBJECTIVE: The aim of the study was to determine the difference in safety and efficacy between radial and femoral route for angiography.

METHODOLOGY: Patients who presented to our center for angiography were admitted in cardiology ward. Patients were prepared for the procedure overnight. Diabetic patient received normal saline over night at rate of 10ml /hour for 12 hours.  Patient whose serum creatinine was ≥ 2 mg/dl were excluded from the list. Patient randomly divided into two groups, group1 for radial artery approach and group 2 for femoral artery approach. Those patient in whom the radial route was not accessible due to any reason, cross over to femoral angiography. Patient demographic variable, duration of fluoroscopy, length of procedure, amount of contrast used, any complication during and after procedure, time to mobilization and duration of hospital stay were noted. These variables were analyzed on SPSS version 23 for mean, mode and any statistical significance. P value of <0.05 was considered statistically significant.

RESULTS: Total no of patients were 1111. There were 682(61.38%) male and 429(38.61%) female patients. Patient with co-morbidity were 418(37.62%), including diabetes, hypertension and chronic kidney disease.  Mean age of patient for femoral procedure was 55.62±10.28 vs. 54.31±1.08 for radial procedure. Diabetic in femoral route procedure were 28.2% and 27.3% in radial route. About 48.5% were hypertensive in femoral route and 45.3% in radial group. Rate of complication were less in female gender for procedure from the radial route. Fluoroscopy time, radiation duration and CKD were noted having negative association with femoral route. Hospital stay was prolonged with femoral route. Pain, artery spasm and more contrast was noted in radial approach.

CONCLUSION: There was no significant difference in major complication between radial and femoral route.

Keywords: CAD, CKD, DAP, BMI, TVD, SVD, DVD, LMS.