No Greater Stroke Risk Seen With Radial PCI

Mon, 03/18/2013 - 9:33am
Chris Kaiser

Radial access for percutaneous coronary intervention (PCI) was not linked with a significant risk of clinically detected neurologic complications compared with femoral access, a retrospective study found.

During a 5-year period with nearly 500,000 patients, the rate of stroke complications was 0.11% for both radial and femoral access, reported James Nolan, MD, from the University Hospital of North Staffordshire in Stoke-on-Trent, England, and colleagues.

Nor was there a significant difference in stroke rate when using either the left or right radial approach, they wrote in the March issue of the American Heart Journal.

In addition, the rate of neurologic complications – defined as a periprocedural ischemic stroke, hemorrhagic stroke, or transient ischemic attack occurring before hospital discharge – significantly increased over the study period from 0.08% to 0.14% (P<0.001), "with no significant difference between access sites for each year."

Nolan and colleagues suggested this increase in stroke rates could be related to the change in case mix, specifically the increase over time in PCI for acute coronary syndromes (ACS) patients (47% to 61%, P≤0.0001), along with their concomitant use of "more intensive antithrombotic regime increasing the risk of cerebral bleeding events."

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