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

Abstract

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.