Radial versus Femoral Approach for Left Ventricular Endomyocardial Biopsy.

Abstract

AIMS: Left ventricular endomyocardial biopsy (LV-EMB) is mostly performed via the femoral artery. We assessed the feasibility and safety of radial versus femoral access in patients undergoing LV-EMB. METHODS AND RESULTS: 264 patients from four countries undergoing LV-EMB were collected. Clinical, procedural, safety and feasibility data were compared between groups. LV-EMB was successfully performed via radial approach in 129 (99%) of 130 and 134 (100%) patients by femoral access. Patients in the radial group were older (55.7 versus 44.3 years) and more likely to have moderate-severe mitral regurgitation (27.7% versus transfemoral 0%). Sheathless guides were used in 108 (83.1%) radial and 2 (1.5%) femoral patients; the mean guiding catheter size (radial 7.0±1.0-French versus femoral 8.0±0.1-French, P<0.001) was smaller in the radial group. Mild/moderate radial artery spasm occurred in 13 (10.0%) patients and 1 (0.8%) patient required conversion to femoral access due to severe spasm. No access-site related complications were reported in the radial group while 11 (8.2%) patients in the femoral group had access-site hematomas (P=0.001). There were no major complications in either group. CONCLUSIONS: Radial approach for LV-EMB is feasible and safe, with fewer access-site bleeding complications compared to femoral access. These results study support radial approach for LV-EMB.