Radial versus femoral approach for high‐speed rotational atherectomy

Objective : The aim of this study was to compare in‐hospital outcomes for patients undergoing high‐speed rotational atherectomy (HSRA) via the radial and femoral route. Background : Transradial access is often avoided for HSRA because of concern over limitations on guide catheter size. No studies have compared a radial and femoral approach for HSRA. Methods : This is a retrospective comparison of in‐hospital outcomes for 151 consecutive patients (75 radial, 76 femoral) undergoing HSRA. Results : Significantly smaller diameter guide catheters (6.3 ± 0.5 Fr vs. 7.1 ± 0.8 Fr, P < 0.001) and burrs (1.6 ± 0.2 mm vs. 1.7 ± 0.2 mm, P = 0.02) were used in the radial compared with the femoral group. Procedural success (93.3% vs. 94.7%, P = 0.75), procedure time (108.7 ± 30.5 min vs. 112.8 ± 35.0 min, P = 0.45), and patient radiation exposure (12125 ± 8373 vs. 12118 ± 7831 cGy cm 2 , P = 1.00) were similar in radial and femoral groups. There was a trend in favor of radial artery access for major access site bleeding complications (0.0% vs. 5.3%, P = 0.12). The incidence of in‐hospital death or myocardial infarction was low in both groups. Conclusion : This study shows that radial artery access is a feasible, safe, and effective approach for HSRA. Overall complication rates are low and radial access may be associated with a lower risk of major bleeding complications compared with a femoral approach. © 2009 Wiley‐Liss, Inc.