Settings Success, Efficacy and Predictors of Failure of Transradial Approach For Coronary Intervention in Nepalese Population: A Cross-Sectional Study

Abstract

Introduction: Coronary angiography and percutaneous coronary intervention are crucial in coronary artery disease management. The transradial artery (TRA) approach offers advantages, but its success may vary among patients. In Nepal, understanding TRA outcomes is essential due to unique characteristics and high cardiovascular disease burden. This study investigates TRA success, efficacy, and predictors in Nepalese patients.

 Methods: A hospital-based prospective cross-sectional study was conducted at Birat Medical College Teaching Hospital from January 25, 2023, to May 30, 2023. A total enumeration sampling technique was used to enrol 234 participants.  Data on demographic profiles, procedure details, success, efficacy, and predictors of failure were collected using a structured questionnaire. Success and efficacy were measured as the percentage of successful accesses and completed procedures, respectively. Fisher's exact test was used for statistical analysis (p<0.05).

Results: The study found a high procedural success rate (95.73%) and efficacy (95.73%) of transradial access. Most patients (97.65%) undergoing CAG and 90.62% undergoing PCI achieved successful TRA. The failure rate was 4.27%, with higher failure in PCI (9.38%) compared to CAG (1.7%). The median duration for achieving TRA access and successful completion for CAG and PCI was 21 sec, 26 seconds, 5 minutes and 20 minutes, respectively.

Conclusion: This study highlights the high procedural success rate and efficacy of trans-radial access for cardiac procedures. The low failure rate demonstrates the feasibility and effectiveness of trans-radial access. While certain factors may contribute to failure, no statistically significant associations were observed.