Angiography is a test to diagnose blockages in heart arteries. Angioplasty is the procedure to open the blocked heart arteries. These are performed through the groin( femoral access) or hand( radial access).
Safety of angioplasty and angiography has improved considerably in the last 2 decades with use radial instead of femoral access.
Several hemostatic devices are available to mitigate bleeding risk with femoral access; which though safe cannot match the safety of radial access. This paper has been cited by other publications.
Publication
Safety of transradial access compared to transfemoral access with hemostatic devices (vessel plugs and suture devices) after percutaneous coronary interventions: A systematic …
Yashasvi Chugh, Chirag Bavishi, Mohammad K Mojadidi, Islam Y Elgendy, Robert T Faillace, Emmanouil S Brilakis, Jacqueline Tamis‐Holland, Mamas Mamas, Sanjay Kumar Chugh
Catheterization and Cardiovascular Interventions 96 (2), 285-295, 2020
Method
Electronic database were systematically searched for all pertinent studies from inception through January 2020.
Results
Twelve studies (8 observational, 4 randomized) including 7,961 patients (TRA: 3,121 patients, TFA and vessel plugs: 3,157 patients, TFA & suture devices: 1,683 patients) were included in the analysis. Major bleeding was significantly lower with TRA compared with TFA and vessel plugs (odds ratio [OR] 0.22, 95%CI 0.11–0.44, p < .00001) and TFA & suture devices (OR 0.12, 95%CI 0.05–0.28, p < .00001). Vascular complications were significantly lower with TRA compared to TFA and vessel plugs (OR 0.25, 95%CI 0.13–0.49, p < .0001) and TFA & suture devices (OR 0.13, 95%CI 0.04–0.41, p = 0.0005). Rates of closure device failure were lower for TRA compared to TFA & suture devices (OR 0.13, 95%CI 0.04–0.41, p = .0005), but similar to TFA & vessel plugs (OR 0.23, 95%CI 0.01–4.28, p = .33), although confidence intervals were wide.
Conclusion
TRA with conventional hemostasis is safer than TFA with hemostasis via vessel plugs or suture devices and should be considered best practice.
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