Dr KK Answers: Which one is better angioplasty though hand or thigh?

Thigh femoral artery is preferred route for angioplasty but is associated with a significant risk of bleeding. The hand radial artery offers the potential advantage of being compressible.

 The RIVAL trial randomly assigned 7021 patients to either thigh femoral or hand radial artery access.  At 30 days, there was no significant difference in the rate of death, heart attack, paralysis, or non coronary artery bypass graft related major bleeding.

The outcomes were more favorable for hand radial artery approach in
1.    Patients who underwent hand radial artery access in centers that performed many such procedures
2.    Those with ST-segment elevation myocardial infarction.

Source: Lancet 2011; 377:1409