Background

The tranradial intervention (TRI) has several advantages such as reduction of bleeding risk, improvement of patients' convenience, and immediate ambulation as compared with the transfemoral intervention (TFI). In TRI, there are some anatomical and technical differences between right and left radial approach. The aim of this study is to evaluate the impact of the choice of the right or left radial approach on 12 months clinical outcomes in patients undergoing TRI.

Methods

A total of 1,653 consecutive patients underwent TRI were enrolled from Nov 2004 to Oct 2010 in Korean TRI Registry. The patients were divided into two groups; right radial approach group (n=792 pts) and left radial approach group (n=861 pts). To adjust potential confounders, propensity score matched (PSM) analysis was performed using the logistic regression model (C-statistics: 0.726). After PSM, total of 1,100 pts (550 pairs) were enrolled for this analysis.

Results

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

Conclusion

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

Copyright © 2014 Published by Elsevier Inc.