Transluminal coronary angioplasty: comparison of brachial and femoral artery methods.

The brachial and femoral artery methods for (percutaneous) transluminal coronary angioplasty are compared. We attempted 901 angioplasties with 539 (59.8%) via the brachial and 362 (40.2%) via the femoral artery. The stenosis was crossed in 670 attempts (74%); in 410 (76%) via the brachial, and in 260 (72%) via the femoral artery. Successful angioplasty was achieved in 607 attempts (67%): in 370 (69%) via the brachial, and in 237 (65%) via the femoral artery. There was no difference between the techniques in crossing the stenosis or achieving a primary success. The left anterior descending artery stenosis was statistically more likely to be crossed than a stenosis in the right (p less than 0.001), circumflex (p less than 0.05), left main coronary artery (p less than 0.05), or saphenous vein graft (p less than 0.05); the left anterior descending artery stenosis was more likely (p less than 0.05) to be successfully dilated if the lesion were crossed (410 of 445 cases, 92%) than a right coronary stenosis (117 of 136 cases, 80%). The brachial and femoral artery methods are comparable techniques. Interventional angiographers performing coronary angioplasty should utilize the angiographic approach with which they are most familiar.