Which Cardiac Catheterization Procedure is Associated with Fewer Complications: Transradial or Transfemoral?

Purpose: To determine which approach between the Transfemoral approach (TFA) and Transradial approach (TRA) is associated with fewer clinical complications in adults over the age of 40 requiring cardiac catheterization or percutaneous coronary intervention.

Method: The Population, Intervention, Comparison, and Outcomes (PICO) framework was used to answer the aim of the project.  Databases such as CINAHL and PubMed were used to retrieve pertinent literature spanning the years between 2009 and 2014. Articles were searched by using specific keywords such as “cardiac catheterization approaches” and “percutaneous coronary intervention approaches.”

Results:The TRA showed reduced time of patient immobility, and a decrease in common complications including: bleeding at access site, formation of hematoma, and vascular complications. Likewise reduced morbidity, length of hospital stay, and costs were found using the TRA approach.  Although the TFA was associated with less cannulation time, less use of contrast media, and a greater success rate at site of puncture, the TRA is associated with better patient outcomes.

Conclusion: The TRA was associated with fewer clinical complications among adults undergoing cardiac catheterizations or percutaneous coronary interventions. Although this approach was associated with better patient outcomes, the inadequate use of the TRA in the US may be due to the learning curve of  interventional cardiologists.