Feasibility and Safety of Elective Transradial Coronary Intervention in Asian Females

Background. Transradial access for angioplasty and percutaneous intervention (PCI) has become more popular across the world due to lower risk of bleeding and better patient comfort. It has been shown to be effective and feasible in the Western population. However, there is a relative paucity of similar data for small-statured females, especially from Asian countries. Given the increased theoretical risk of local complications due to smaller-sized radial arteries in such females, feasibility and safety of transradial PCI (rPCI) needs to be better established in this group. Methods. We present observational data for rPCI from a 3-year period at a single tertiary care center in South Asia. Data were collected on all female patients who underwent rPCI from January 2005 to December 2007. Primary outcomes assessed were procedure failure rate and complication rate. Secondary outcomes included death, recurrence of myocardial infarction., anginal symptoms or other complaints. Outcomes were recorded post-procedurally in the hospital and after discharge for up to 6 months. Results. A total of 93 patients were included for final data analysis. Average patient age was 57.5 +/- 10.3 years, with average height of 151.7 +/- 8.4 cm and average weight of 58.1 +/- 12.5 kg. Seventy patients (75.3%) underwent angioplasty or percutaneous intervention (PCI) for ACS and 23 (24.7%) for chronic stable angina refractory to medical therapy. A total of 118 lesions were treated in 90 patients. Ninety-one lesions (77.1%) were classified as Type B2 and Type C according to modified American College of Cardiology/American Heart Association lesion morphology criteria. Three cases of procedure failure accounted for a failure rate of 3.23%. No specified complications were noted in any of the patients. At 6-month follow-up, no deaths were observed. Two patients developed acute myocardial infarction and 16 patients (17.7%) had recurrence of anginal symptoms. Conclusion. Radial artery angioplasty and stenting is feasible and safe in Asian females. Increased theoretical risk of complication due to small-sized radial arteries in this subgroup is unlikely, to be true. Success rates are likely to be good even with complex coronary inventions performed with transradial access.