COMPARISON OF RADIAL ACCESS VERSUS FEMORAL ACCESS WITH THE USE OF A VASCULAR CLOSURE DEVICE FOR EASE OF OPERATION, PROCEDURE TIME, AND VASCULAR COMPLICATIONS IN PATIENTS UNDERGOING PERCUTANEOUS CORONARY INTERVENTION - A RETROSPECTIVE STUDY

Abstract

Background: Arterial access is a significant site of haemorrhagic complications following invasive coronary interventions. The radial approach is a recognised strategy for reducing vascular complications. Vascular closure devices (VCD) enhance patient comfort and reduce hemostasis and the need for bed rest. Nonetheless, the lack of consistent data showing their safety limits their routine adoption as a method to avoid vascular complications. Aim: The study aimed to compare transradial access (TRA) and transfemoral access (TFA) using VCD for ease of operation, procedure time, vascular complications, ambulation time, and hospital length of stay (LOS) among Palestinian patients undergoing percutaneous coronary intervention (PCI). Method: A quantitative, retrospective study design was used. The subjects in the current study were all patients admitted to the catheterisation unit at An-Najah National University Hospital (NNUH) for PCI. The sample was 200 patients with PCI using the TRA or TFA using the VCD procedure. Result: The results showed the highest statistical significance in complications among TFA with CVD group compared to the TRA group for numbness (37.5% vs. 24.2%, P= 0.025*), soreness (15.8% vs. 5%, P= 0.006*), arterial occlusion (16.7% vs. 5.8%, P= 0.008*), , Arteriole us fistula (10.8% vs. 0.8%, P= 0.001*), compartment syndrome (15% vs. 0%, P= 0.000*), infection (15.8% vs. 2.5%, P= 0.000*), leg ischemia (14.2% vs. 0%, P= 0.000*), and pseudoaneurysm (10% vs. 0%, P= 0.000*), respectively. In contrast, there is statistically significant complications among TFA with the CVD group compared to the TRA group for patient discomfort (26.7% vs. 41.7%, P= 0.014*). The findings indicated that the two groups' access site pain was approximately similar, 55% vs. 58.3%, respectively (P>0.05). Furthermore, time to ambulation was not statistically significant among the TFA with VCD group compared to the TRA (P>0.05). Conclusion: TFA with VCD was associated with longer ambulation time and hospital LOS but shorter time to hemostasis. Vascular complications such as arterial occlusion and leg ischemia were higher in the TFA with VCD compared to TRA, while patient discomfort was lower.