Radial access tied to lower mortality, bleeding, and vascular complications
By Lori Solomon HealthDay Reporter
THURSDAY, May 16, 2024 (HealthDay News) — Use of radial access for percutaneous coronary intervention (PCI) increased 2.8-fold in the United States between 2013 and 2022, according to a study presented at the annual meeting of the Society for Cardiovascular Angiography and Interventions, held from May 2 to 4 in Long Beach, California.
Reza Fazel, M.D., from the Beth Israel Deaconess Medical Center in Brookline, Massachusetts, and colleagues used data from the National Cardiovascular Data Registry CathPCI Registry (roughly 2.24 million procedures; Jan. 1, 2013, through June 30, 2022) to compare the safety of radial versus femoral access for PCI.
The researchers found that during the study period, 61.6 percent of procedures were performed via radial access (increasing from 23.9 percent in 2013 to 68.2 percent in 2022). All geographic regions and the full spectrum of presentations experienced increases, with the largest relative increase seen in patients with ST-segment elevation myocardial infarction. Radial access was significantly associated with lower in-hospital mortality (absolute risk difference [ARD], −0.15 percent), major access site bleeding (ARD, −0.64 percent), and other major vascular complications (ARD, −0.21 percent). However, there was a significantly higher risk for ischemic stroke (ARD, 0.05 percent). No differences were seen for the falsification end point of gastrointestinal or genitourinary bleeding.
“It confirms that the benefit observed for radial access in randomized controlled trials has also been seen in real-world practice, including the largest benefits for the highest-risk patients,” Fazel said in a statement.
Several authors disclosed ties to the pharmaceutical and medical device industries.
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