SCAI: Transradial Access Reduces Need for Transfusion in PCI

ORLANDO, May 10 -- Compared with femoral access, percutaneous coronary interventions done by threading a catheter from the arm to the heart, known as transradial access, reduced transfusions and mortality, researchers here reported.

In a retrospective analysis, radial access was associated with a halving of the transfusion rate, 1.4% versus 2.8% for femoral access, said Alex J. Chase, M.D., Ph.D., a cardiologist at the Bristol Regional Heart Center in Bristol, England

Also, there was a small but statistically significant reduction in the absolute mortality rate at one year from 0.04% with femoral access to 0.03% with radial access (P <0.001), Dr. Chase reported today at the Society of Cardiovascular Angiography and Interventions meeting.

He noted that published studies have reported that transradial PCI shortened hospital stay and reduced bleeding.

He conducted a retrospective analysis of data from three percutaneous coronary interventions registries in British Columbia and identified 38,995 patients from 1999 through 2005, They were cross-referenced to the British Columbia transfusion registry to identify patients who required transfusion within nine days of a percutaneous coronary interventions.

Mortality at 30 days, six months and one year were obtained from vital statistics databases.

Among the findings:

• A total of 31,001 patients had femoral access percutaneous coronary interventions and 7,994 had radial access.
• Nine hundred seventy-eight patients received transfusions-868 of those patients had femoral access procedures.
• The 30-day mortality for femoral access patients who received transfusions was 13% versus 1.4% morality for patients who were not transfused. For radial access patients who were transfused the 30-day mortality was 8.2% versus 0.9% for patients who were not transfused.
• After adjusting for all risk factors, transfusion was associated with a 5.6% increase in mortality (P <0.001).