Radial Versus Femoral Access for Diagnostic Coronary Angiography: Insights From a Tertiary Academic Center in Johannesburg.

BACKGROUND

The radial artery is the preferred access for performing diagnostic coronary angiograms (DCA). However, data on the safety and efficacy of radial compared to femoral access in low- and middle-income countries is limited.

AIMS: This study aims to evaluate the safety and efficacy of radial versus femoral access in patients referred for a DCA.

METHODS

We conducted a cross-sectional, retrospective study on patients referred for DCA to evaluate the safety and efficacy of radial versus femoral access routes.

RESULTS

The study population comprised 653 patients with a mean age of 58.2 ± 12.7 years, of which 408 (62.5%) were males. Radial access was utilized in 318 (48.7%) patients. The median duration of the radial access was 50 min (Interquartile range [IQR]: 40-60) and was longer than that of the femoral artery access, which had a median duration of 45 min (IQR: 35-60) (p = 0.010). The median total radiation dose emitted during the DCA in the femoral access group was 3511 milligray per square meter (mGy/m²), (IQR: 2154-5821), and patients in the radial access group received a median radiation dose of 4011 mGy/m² (IQR: 2298-6411) (p = 0.0661). The mean contrast volume administered in the radial and femoral artery access group did not differ significantly, measuring 83.7 ± 36.1 milliliters (mL) and 88.9 ± 37.1 mL, respectively (p = 0.073).

CONCLUSIONS

Radial access was used in nearly half of all DCA, reflecting its growing adoption in clinical practice. These findings support the use of radial access as a safe and viable alternative to femoral access, even in resource-limited settings.