• Mansour Sallam, Hafidh Al-Hadi, S Rathinasekar, and Sunil Chandy.
• Cardiology Unit, Department of Medicine, Sultan Qaboos University Hospital, Muscat, Sultanate of Oman.
• Sultan Qaboos Univ Med J. 2009 Dec 1;9(3):272-8.

ObjectivesFemoral artery access is the standard approach for coronary procedures; however, the radial approach has gained sound recognition as an alternative to femoral access. We present our early experience with the transradial approach.MethodsA prospective, non-randomised study of 221 candidates for diagnostic coronary angiography was carried out at Sultan Qaboos University Hospital, Oman between December 2008 and April 2009. The patients had their procedure performed from radial or femoral access according to operator discretion and the results were compared. Femoral and radial groups included 116 and 105 patients respectively.ResultsRadial access was associated with a significantly higher rate of procedural failure (17.1%) versus 0% in femoral group (p = 0.001). There were no local vascular complications in the radial group as opposed to 12.1% in the femoral group (p < 0.01). Hospital length of stay was significantly reduced in the radial group (4.06 versus 23.5 hours, p < 0.01). Total procedure time was longer in the radial group (23.7 ± 13.7 min versus 20.1 ± 7.4 min, p < 0.001), but radiation exposure was similar in both groups. There was a trend for a higher risk of major adverse cardiac events noticed in the femoral group; however, it did not reach statistical significance.ConclusionThe transradial approach for coronary angiography is associated with significantly reduced local vascular complications and shorter hospital stays. The femoral approach is the standard access site for coronary angiography; however, interventional cardiologists should acquire experience in the radial approach as an alternative in specific situations.

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