RAndomized Comparison of raDIal vs. femorAL Access for Routine Catheterization of Heart Transplant Patients (RADIAL – Heart Transplant Study)

• Published in: Transplantation proceedings 2014-12, Vol.46 (10), p.3262-3267
• Main Authors: Scalone, G, Brugaletta, S, Martín-Yuste, V, Seixo, F, Cotes, C, Gómez-Monterrosas, O, Alvarez-Contreras, L, Campreciós, M, Mirabet, S, Brossa, V, Sabaté, M
• Format: Article
• Language: English
• Subjects: Aged; Catheterization - methods; Coronary Angiography - methods; Female; Femoral Artery; Heart Transplantation; Humans; Length of Stay - trends; Male; Middle Aged; Prospective Studies; Radial Artery; Surgery; Treatment Outcome
• ISSN: 0041-1345; 1873-2623
• DOI: 10.1016/j.transproceed.2014.09.147

Abstract Although a transradial approach (TRA) is considered feasible in many clinical situations, no data are available in patients undergoing orthotopic heart transplantation (OHT). Our goal was to randomly compare TRA versus a transfemoral approach (TFA) in this clinical setting. This single-center, prospective, randomized trial was conducted from January to November 2006, and all OHT patients scheduled for a control coronary angiography were randomized to receive TRA or TFA. The primary endpoint was the amount of contrast used during the procedure. The participating interventional cardiologists were intermediate-volume radial operators, and this was their initial experience of TRA in OHT patients. The analysis was performed according to the intention-to-treat principle. Overall, 49 patients (mean age, 55 ± 13 years; 74% male) were included in the trial: 26 patients were assigned to TRA, and 23 were assigned to TFA. A higher amount of contrast (147 mL [range, 113–175 mL] vs 105 mL [range, 86–127 mL]; P  = .009), a longer fluoroscopy time (9.2 minutes [range, 6–12 minutes] vs 3.5 minutes [range, 3–5 minutes]; P  < .001), a trend toward increased number of catheters used for left ostium cannulation, and a higher crossover rate (19% vs 0%; P  = .03) were associated with TRA compared with TFA. Furthermore, patients treated with TRA exhibit a shorter hospital stay (6 [range 4–8]) compared with the other group (26 [range 24–28]) ( P