Background

The radial artery (RA) approach for percutaneous coronary intervention (PCI) has several advantages such as reduction of bleeding risk, improvement of patients’ convenience, and immediate ambulation as compared with the femoral artery approach for PCI. In RA approach for PCI, there are some anatomical and technical differences between right and left RA approach. The aim of this study is to evaluate the impact of the choice of the right or left RA approach on 12 months clinical outcomes in the patients undergoing transradial intervention.

Methods

A total of 1,653 consecutive patients undergoing PCI via radial were enrolled between November 2004 to October 2010 in Korean Transradial Intervention Registry. The patients were divided into two groups such as right approach group (n=792 pts) and left approach group (n=861 pts). To adjust potential confounders, propensity score matched analysis was performed using the logistic regression model (C-statics: 0.726). After propensity score match (PSM), total of 1,100 pts were enrolled for this analysis (MVS: n=550 pts, SVS: n=550 pts).

Results

After PSM, the baseline clinical and angiographic characteristics were balanced between two groups. However, contrast volume during procedure were larger in right approach group (259.3 ± 119.6 cc vs.227.0 ± 90.7 cc, p-value <0.001), procedure time (49.2 ± 30.4 min vs. 55.4 ± 28.7 min, p-value=0.003) were longer in left approach group, and fluoroscopic time (22.5 ± 28.0 min vs. 17.1 ± 12.6 min) were longer in right approach group. After PSM, procedural and in-hospital complications were similar between two groups. After PSM, cumulative clinical outcomes up to 12 months including mortaility, recurrent myocardial infarction (MI), revascularization, and stent thrombosis were similar between two groups.

Conclusions

In this study, the procedural efficacy including procedural time and contrat volume increased in right artery approach. However, 12 months cumulative clinical outcomes were similar between two groups.

Copyright © 2014 American College of Cardiology Foundation. Published by Elsevier Inc. All rights reserved.