Abstract P281: Impact of Transradial Approach on Quality of Care for Percutaneous Coronary Intervention: A Single Center Experience

Background: Transradial cardiac catheterization has only been used in a small fraction of percutaneous coronary intervention (PCI) procedures in the United States, despite of the evidence that it may be associated with a lower risk of bleeding and mortality following PCI compared to the transfemoral approach. Objective: To evaluate the impact of the transradial approach on adverse outcomes following PCI and its potential of being a process to improve the quality of care for PCI in a single-center practice. Methods: We compared the risks of post-procedural adverse outcomes including in-hospital mortality, bleeding, and vascular complications between the 462 transradial and the 625 transfemoral cases who had undergone PCI procedures between January 2007 and March 2009. The difference in length of stay following PCI between the two entry approaches was also examined. Results: Compared to the transfemoral approach, the transradial cardiac catheterization was associated with significantly lower risk of bleeding (2.60% (12 of 462) vs. 6.08% (38 of 625); adjusted odds ratio (aOR)=0.34, 95% confidence interval (CI): 0.17-0.68, P=0.002) and vascular complications (0% vs. 1.44% (9 of 625), P=0.01). Although the trend was that the transradial approach was associated with lower risk of in-hospital mortality, the difference was not statistically significant (0.87% (4 of 462) vs. 2.24% (14 of 625); aOR=0.55, 95% CI: 0.14-2.10, P=0.38). Transradial patients were more likely to be discharged on the same day of procedure (14.2% vs. 2.2%, P Conclusion: The transradial approach is related to lower risk of bleeding and vascular complications. Introducing this approach to practice could improve the quality of care for PCI.