title: The transradial approach during transcatheter structural heart disease interventions: a review.
abstract: OBJECTIVE
  To review the safety and feasibility of a transradial (TR) approach during transcatheter structural or congenital heart disease interventions when utilized as either as a primary or secondary arterial access site.
  
  
  RESULTS
  Studies and case reports published between 2002 and 2014 utilizing the TR access during transcatheter structural and congenital heart disease interventions during alcohol septal ablation (ASA), ventricular septal defect (VSD), renal denervation (RD), paravalvular leak (PVL) closure, transcatheter aortic valve implantation (TAVI, secondary access) and endovascular repair of aortic coarctation (ERAC, secondary access) were evaluated. Access-site (femoral vs. TR) vascular and bleeding complications were assessed. Femoral access complications ranged from 0.16% to 40%, with an overall incidence of 2.2% (56/2521). There were 18 reports or studies specifically evaluating the utility of TR access in the context of transcatheter structural heart disease interventions (ASA: 3; VSD: 1; RD: 3; PVL closure: 1; TAVI: 7, ERAC: 3). The use of TR access either as primary or secondary access site was feasible and allowed the completion of the procedure in all cases. The overall incidence of access-site complications following a TR approach was 0.5% (2/406 patients), with no major vascular or bleeding complications.
  
  
  CONCLUSIONS
  A TR approach during transcatheter structural heart disease interventions appears to be a safe, effective means of delivering high procedural success accompanied by lower bleeding complications compared with the transfemoral approach.
authors.affiliation: Quebec Heart & Lung Institute, Quebec City, QC, Canada.
authors.forename: Ricardo
authors.initials: R
authors.lastname: Allende
authors.forename: Henrique B
authors.initials: HB
authors.lastname: Ribeiro
authors.forename: Rishi
authors.initials: R
authors.lastname: Puri
authors.forename: Marina
authors.initials: M
authors.lastname: Urena
authors.forename: Omar
authors.initials: O
authors.lastname: Abdul-Jawad
authors.forename: María
authors.initials: M
authors.lastname: del Trigo
authors.forename: Gabriela
authors.initials: G
authors.lastname: Veiga
authors.forename: Maria del Rosario
authors.initials: Mdel R
authors.lastname: Ortas
authors.forename: Jean-Michel
authors.initials: JM
authors.lastname: Paradis
authors.forename: Robert
authors.initials: R
authors.lastname: De Larochellière
authors.forename: Josep
authors.initials: J
authors.lastname: Rodés-Cabau
mesh_terms: D055011:Ablation Techniques / Q000379:methods; D017130:Angioplasty / Q000009:adverse effects / Q000379:methods*; D006328:Cardiac Catheterization / Q000009:adverse effects / Q000379:methods*; D002312:Cardiomyopathy, Hypertrophic / Q000628:therapy; D000431:Ethanol / Q000627:therapeutic use; D005240:Feasibility Studies; D005260:Female; D006330:Heart Defects, Congenital / Q000601:surgery*; D006344:Heart Septal Defects, Atrial / Q000601:surgery; D006801:Humans; D007668:Kidney / Q000294:innervation; D008297:Male; D008875:Middle Aged; D061214:Patient Safety; D012997:Solvents / Q000627:therapeutic use; D013562:Sympathectomy / Q000379:methods; D065467:Transcatheter Aortic Valve Replacement / Q000379:methods
chemical_list: D012997:Solvents; D000431:Ethanol
keywords: Bleeding; structural heart disease; transradial; vascular complications