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Safety and efficacy of transradial right and left heart catheterization compared with transfemoral approach: an initial experience

BACKGROUND: Right and left heart catheterization (RLC) is a limitation on the use of the transradial technique (TRT). However, recent studies have shown that the procedure can be safely performed with the use of a forearm venous access. In this study, it was evaluated the use of this new approach compared with the transfemoral technique (TFT). METHOD: Between January 2006 and June 2008, 70 patients were submitted to RLC. From September 2007 on, TRT was adopted as the first choice technique. Venous access in the TRT was obtained by puncturing a forearm vein using a JelcoTM 20 catheter. This study aimed to evaluate TRT safety and effectiveness compared with TFT through the procedure success rates, occurrence of in-hospital complications related to the puncture site, as well as procedure and fluoroscopy times. RESULTS: Among the 70 patients evaluated, 35 had undergone the procedure through TRT and 35 through TFT. The groups were well matched, with no significant differences in baseline clinical characteristics, except for the higher percentage of patients using oral anticoagulant in the TRT group (p = 0.005). The procedure success rate was 97.1% in TRT and 100% in TFT (p > 0.99). In one case in the TRT group it was not possible to advance the introducer through the forearm venous access, and the technique was converted to TFT. The mean duration of the procedure was significantly shorter in the TRT group compared with the TFT group (28.28 ± 10.21 min vs. 42.85 ± 20.33 min; p = 0.0004). The fluoroscopy time was 6.17 ± 2.42 min in TRT and 8.39 ± 6.38 min in TFT (p = 0.060). There were 6 cases of minor bleeding from the puncture site in the TFT group and none in the TRT group (p = 0.024). CONCLUSIONS: Performing RLC using TRT was safe and effective. It is a useful alternative to standard TFT approach, reducing procedure duration, vascular complications, and possibly procedure costs.

Radial artery; Femoral artery; Femoral vein; Heart catheterization


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