Comparing radial and femoral access for coronary angiography and interventions.
Cardiac catheterization and coronary intervention via the radial approach is increasingly adopted as the preferred vascular access to avoid transfemoral vascular complications. Recent clinical trials have confirmed that radial access reduces vascular complications and local bleeding with similar procedural efficacy. Transradial access has inherent technical challenges, including smaller vessel size of the radial artery, arterial spasm and tortuosity involving the radial and subclavian arteries, which may undermine the procedural success of this approach. A number of strategies have been reported to minimize complications of radial access, including the use of hydrophilic introducer sheaths and smaller sheath sizes, administration of nitroglycerin and unfractionated heparin during the procedure, patent hemostasis of the radial artery and careful patient selection. Operators experienced in transradial percutaneous coronary intervention can achieve comparable clinical outcomes to the transfemoral approach and minimize vascular complications. Radial artery access is likely to become widely accepted as the preferred percutaneous coronary intervention approach.
McMaster University, 237 Barton Street East, Hamilton, ON, L8L 2X2, Canada.
Victar
V
Hsieh
Sanjit
S
Jolly
D001157:Arterial Occlusive Diseases / Q000209:etiology / Q000517:prevention & control; D017023:Coronary Angiography / Q000009:adverse effects / Q000379:methods*; D001026:Coronary Artery Bypass / Q000379:methods; D005263:Femoral Artery; D006801:Humans; D059032:Learning Curve; D009203:Myocardial Infarction / Q000628:therapy; D057240:Patient Preference; D062645:Percutaneous Coronary Intervention / Q000379:methods; D017534:Radial Artery; D016032:Randomized Controlled Trials as Topic; D013035:Spasm / Q000209:etiology; D020521:Stroke / Q000209:etiology