Coronary disease & ACSCohort study
Radial vs femoral access for percutaneous coronary intervention: temporal trends and outcomes in the USA
- Retrospective cohort study
- instrumental variable analysis
- NCDR CathPCI Registry
Authors' conclusion
Based on instrumental variable analyses, PCI with radial access site had lower rates of in-hospital mortality, major access site bleeding, and other major vascular complications compared with femoral access site but a slightly higher risk of ischaemic stroke in contemporary practice.
Study context
- Population
- Percutaneous Coronary Intervention (PCIs) in the US NCDR CathPCI Registry, 1 January 2013 to 30 June 20222,420,805 in safety analysis
- Participants
- 6,658,479 participants
- Exposure
- Radial vs femoral access for PCI
- Radialn = 2,690,355
Main finding
As reported in the abstract
Radial access use (temporal trend) and comparative safety
Absolute risk difference (ARD), %
- in-hospital mortality
- −.15 (95% CI −.20 to −.10)
- major access site bleeding
- −.64 (95% CI −.68 to −.60)
- other major vascular complications
- −.21 (95% CI −.23 to −.18)
- ischaemic stroke (higher with radial)
- .05 (95% CI .03-.08)
- PCIs via radial access overall
- 40.4%
- Radial access in 2013
- 20.3%
- Radial access in 2022
- 57.5%
Observational data: associations, not effects.
Further findings
Falsification endpoint: gastrointestinal or genitourinary bleeding
- No association with the falsification endpoint (instrumental variable analysis)
- ARD .00%, 95% CI −.03-.03
Original publication
Radial vs femoral access for percutaneous coronary intervention: temporal trends and outcomes in the USA. Eur Heart J. Published 4 July 2025. doi:10.1093/eurheartj/ehaf426
Summarised from the published abstract; every number is checked against it