Study lends additional support for TRA over TFA for coronaryangiography or PCI with lower 30-day mortality and major bleeding, but still leaves the question of why patients live longer unanswered. ESCCongress CardioTwitter
European and American guidelines endorse preferential use of transradial access over transfemoral access , however, debate continues to swirl over a survival benefit because it has been seen in some but not all TRA trials, he noted.
In an intention-to-treat analysis, all-cause mortality at 30 days was 1.6% with TRA and 2.1% with TFA corresponding to a 23% relative risk reduction . The number needed to treat to prevent one death was 214. Major bleeding was also lower with TRA than with TFA, with a relative risk reduction of 45%, absolute reduction of 1.2% , and number need to treat of 84. This benefit was consistent regardless of the bleeding definition used.
"These data strongly support radial intervention in these settings but provide some reassurance, predominantly to femoral operators or when transradial axis is difficult," Stone said. "So we still have a ways to go in understanding the mechanisms underlying the mortality benefit of transradial access in select subgroups," Stone said.
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