Radial access cuts vascular complications in angiography

(HealthDay)—Women undergoing coronary angiography and percutaneous coronary intervention (PCI) have a higher rate of vascular complications than men, which are significantly reduced with radial access, according to a study published in the April 20 issue of JACC: Cardiovascular Interventions.

Shaheen Pandie, M.B., Ch.B., from McMaster University and Population Health Research Institute in Hamilton, Canada, and colleagues determined the efficacy and safety of radial versus femoral access among women undergoing coronary angiography/intervention. Outcomes were compared for 1,861 women and 5,160 men randomized to radial versus femoral access.

The researchers found that the risk of major vascular complications was higher for women than men (4.7 versus 1.7 percent; P < 0.0001). In women and men, major vascular complications were significantly reduced with radial access (hazard ratios, 0.5 and 0.27, respectively). In women and men, crossover rates were higher with radial versus femoral access (hazard ratios, 5.88 and 3.32, respectively). Similar PCI success rates were observed, regardless of access site, with no differences in PCI complications. Female sex was an independent predictor of major vascular complications in multivariable analyses (hazard ratio, 2.39). Findings were consistent for women and men, with no difference for the primary composite end point (death, myocardial infarction, stroke, and non-coronary artery bypass graft bleeding).

"Women undergoing coronary angiography and PCI have a higher risk of vascular access site complications compared with men, and radial access is an effective method to reduce these complications," the authors write.

Two authors disclosed financial ties to the pharmaceutical and medical device industries.

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