Voie d'abord radiale en cardiologie interventionnelle chez la femme

The treatment of cardiovascular disease has considerably evolved over the past 20 years, resulting in a reduction in cardiovascular mortality among the general population. Such improvement in patient outcome may be partly attributed to interventional cardiology procedures. However, these encouraging results are not uniformly observed in men and women and the rate of cardiovascular mortality in female patients remains unchanged. A number of studies have shown a poorer outcome in women with coronary artery disease undergoing percutaneous coronary intervention. Several reasons may explain the difference in post-PCI outcome between men and women. More advanced age and higher percentage of diabetics are documented clinical factors. Other angiographic factors such as vessel size, smaller in the female population, may also account for such a difference. Finally, the occurrence of vascular complications is one of the reasons affecting the outcome of female patients. The radial vascular approach contributes to the reduction in the incidence of complications which may compromise survival. This vascular route may be more complex in the female population because of the size of the radial artery which is smaller than in men. Nevertheless, the transradial approach is very safe and efficient in experienced hands and it is probably one of the techniques which may help close the prognosis gap between men and women undergoing PCI.