Background:
The radial access has been incorporated in many centers as the technique of choice for cardiac invasive procedures. However, there is still resistance to its use, which is mainly related to the possibility of crossover to the femoral access, caused by technical difficulties or vascular anatomic alterations. The aim of this study was to identify the reasons for the use of the femoral access in a center with moderate volume of interventions, which recently adopted it as the technique of choice for invasive cardiac procedures.
Methods:
Prospective study including consecutive patients undergoing elective cardiac catheterization and coronary angiography. A data form was filled out containing pre-, peri-, and postprocedure information, with emphasis on the evaluation of the causes to use the femoral access (crossover or first choice).
Results:
From November 2013 to August 2014, a total of 1,290 patients underwent an elective diagnostic procedure. The femoral access was used in 10.9% of the patients, as the operator's first choice in 6.6% and due to crossover in 4.3% of the cases. Crossover resulted from puncture failure (3.4%), arterial spasm (0.6%), or vascular tortuosity (0.3%). Immediate complications were observed in six patients (0.5%) who developed local hematoma (type I and type II).
Conclusions:
In a moderate-volume center the radial access was incorporated as first choice with safety and a low incidence of crossover to femoral access.