Difference of Radial Access and Femoral Access on Patient Outcomes in Diagnostic Cardiac Catheterization: A Quasi-Experimental Study
DOI:
https://doi.org/10.1891/1748-6254.12.3.73Keywords:
transradial access, transfemoral access, back pain, cardiac catheterizationAbstract
Background: Transfemoral and transradial are two common approaches for performing cardiac catheterization, while there is no consensus on which one is superior to the other.
Aim: This paper aimed to compare the effect of transfemoral and transradial approaches on patient's outcomes in terms of back pain, vascular complications, and urinary discomfort in those undergoing diagnostic cardiac catheterization.
Methods: A secondary data analysis method was used.
Results: The results showed that transradial access could significantly reduce back pain compared to femoral access. While no significant difference was found for vascular complications and urinary discomfort between the two methods.
Conclusion: The findings of this study indicate that transradial approach could reduce patients' back pain without increasing the incidence of vascular complications. Additionally, with early mobility, nursing care time could be reduced. Thus, it can be used as an alternative approach for the transfemoral approach.
References
American Heart Association. (2017). Cardiac catheterization. Retrieved from http://www.heart.org/HEARTORG/Conditions/HeartAttack/SymptomsDiagnosisofHeartAttack/Cardiac-Catheterization_UCM_451486_Article.jsp#.Wfr6XGiCyUk
Bertrand, O. F., Rao, S. V., Pancholy, S., Jolly, S. S., Rodés-Cabau, J., Larose, É, & Mann, T. (2010). Transradial approach for coronary angiography and interventions: Results of the first international transradial practice survey. JACC: Cardiovascular Interventions, 3(10), 1022–1031. doi:10.1016/j.jcin.2010.07.013
Chair, S. Y., Fernandez, R., Lui, M. H. L., Lopez, V., & Thompson, D. R. (2008). The clinical effectiveness of length of bed rest for patients recovering from trans-femoral diagnostic cardiac catheterization. International Journal of Evidence-Based Healthcare, 6(4), 352–390.
Chair, S. Y., Taylor-Piliae, R. E., Lam, G., & Chan, S. (2003). Effect of positioning on back pain after coronary angiography. Journal of Advanced Nursing, 42(5), 470–478. doi:10.1046/j.1365-2648.2003.02646.x
Chair, S. Y., Thompson, D. R., & Li, S. K. (2007). The effect of ambulation after cardiac catheterization on patient outcomes. Journal of Clinical Nursing, 16(1), 212–214. doi:10.1111/j.1365-2702.2006.01599.x
Chair, S. Y., Yu, M., Choi, K. C., Wong, E. M., Sit, J. W., & Ip, W. Y. (2012). Effect of early ambulation after transfemoral cardiac catheterization in Hong Kong: A single-blinded randomized controlled trial. Anatolian Journal of Cardiology, 12(3), 222. doi:10.5152/akd.2012.065
Christenson, R., Staab, E. V., Burko, H., & Foster, J. (1976). Pressure dressings and postarteriographic care of the femoral puncture site. Radiology, 119(1), 97–99. doi:10.1148/119.1.97
Dehmer, G. J., Weaver, D., Roe, M. T., Milford-Beland, S., Fitzgerald, S., Hermann, A., & Brindis, R. G. (2012). A contemporary view of diagnostic cardiac catheterization and percutaneous coronary intervention in the United States: A report from the CathPCI registry of the national cardiovascular data registry, 2010 through June 2011. Journal of the American College of Cardiology, 60(20), 2017–2031. doi:10.1016/j.jacc.2012.08.966
Department of Health, Hong Kong. (2017). Heart diseases. Retrieved from http://www.chp.gov.hk/en/content/9/25/57.html
Feldman, D.N., Swaminathan, R.V., Kaltenbach, L.A., Baklanov, D.V., Kim, L.K., Wong, S.C. (2013). Adoption of radial access and comparison of outcomes to femoral access in percutaneous coronary heart intervention: an updated report from the national cardiovascular data registry (2007-2012). Circulation, 127(23), 2293–2306. https://doi.org/10.1161/CIRCULATIONAHA.112.000536
Goyal, D., Ratib, K., Narain, R., Nolan, J. (2010). Cardiac Catheterization. Medicine, 38(7), 390–394.
Höglund, J., Stenestrand, U., Tödt, T., & Johansson, I. (2011). The effect of early mobilisation for patient undergoing coronary angiography; a pilot study with focus on vascular complications and back pain. European Journal of Cardiovascular Nursing, 10(2), 130–136. doi:10.1016/j.ejcnurse.2010.05.005
Hulme, W., Sperrin, M., Kontopantelis, E., Ratib, K., Ludman, P., Sirker, A., & Nolan, J. (2017). Increased radial access is not associated with worse femoral outcomes for percutaneous coronary intervention in the United Kingdom. Circulation: Cardiovascular Interventions, 10(2), e004279. doi:10.1161/CIRCINTERVENTIONS.116.004279
Jin, C., Li, W., Qiao, S. B., Yang, J. G., Wang, Y., He, P. Y., & Wu, Y. J. (2016). Costs and benefits associated with transradial versus transfemoral percutaneous coronary intervention in China. Journal of the American Heart Association, 5(4), e002684. doi:10.1161/JAHA.115.002684
Jolly, S. S., Yusuf, S., Cairns, J., Niemelä, K., Xavier, D., Widimsky, P., & Avezum, A. (2011). Radial versus femoral access for coronary angiography and intervention in patients with acute coronary syndromes (RIVAL): A randomised, parallel group, multicentre trial. The Lancet, 377(9775), 1409–1420. doi:10.1016/S0140-6736(11)60404-2
Mamas, M. A., Nolan, J., de Belder, M. A., Zaman, A., Kinnaird, T., Curzen, N., & Kontopantelis, E. (2016). Changes in arterial access site and association with mortality in the United Kingdom: Observations from a national percutaneous coronary intervention database. Circulation, 133(17), 1655–1667. doi:10.1161/CIRCULATIONAHA.115.018083
Nathan, S. & Rao, S. V. (2012). Radial versus femoral access for percutaneous coronary intervention: implications for vascular complications and bleeding. Current Cardiology Reports, 14(4), 502–509. doi:10.1007/s11886-012-0287-5
Rao, S. V., Hess, C. N., Barham, B., Aberle, L. H., Anstrom, K. J., Patel, T. B., & Newby, L. K. (2014). A registry-based randomized trial comparing radial and femoral approaches in women undergoing percutaneous coronary intervention: The SAFE-PCI for Women (Study of Access Site for Enhancement of PCI for Women) trial. JACC: Cardiovascular Interventions, 7(8), 857–867. doi:10.1016/j.jcin.2014.04.007
Turk, D. C., & Melzack, R. (2011). Handbook of pain assessment. New York, NY:Guilford Press.
Valgimigli, M., Gagnor, A., Calabró, P., Frigoli, E., Leonardi, S., Zaro, T., … Limbruno, U. (2015). Radial versus femoral access in patients with acute coronary syndromes undergoing invasive management: A randomised multicentre trial. Lancet, 385(9986), 2465–2476. doi:10.1016/S0140-6736(15)60292-6
World Health Organization. (2017). Cardiovascular disease. Retrieved from http://www.who.int/mediacentre/factsheets/fs317/en/
