A comparison of radial and femoral access for cardiac catheterization.
Over the past several years, the transradial approach (TRA) for cardiac catheterization has become increasingly adopted in the United States. The increased utilization of the TRA is grounded on 2 decades of research, showing reduced bleeding and vascular complications to complement improved patient quality of life. However, the concern over cost, radiation exposure, and acknowledged "learning curve" has kept the transfemoral approach (TFA) the mainstay of most US catheterization laboratories. More recent larger multi-centered randomized studies have aimed to address outcomes and these concerns between the TR and TF approaches. This article will review the changing trends in TRA in the US, discuss clinical (bleeding and mortality) and non-clinical (quality of life and cost) outcomes from recent randomized studies, and finally discuss certain aspects when it comes to adopting TRA.
Duke University Medical Center, Durham, NC. Electronic address: john.wagener@dm.duke.edu.
John F
JF
Wagener
Duke Clinical Research Institute, Durham, NC.
Sunil V
SV
Rao
D006328:Cardiac Catheterization / Q000009:adverse effects / Q000379:methods* / Q000639:trends*; D017023:Coronary Angiography / Q000009:adverse effects / Q000379:methods; D005260:Female; D005263:Femoral Artery; D005544:Forecasting; D006801:Humans; D008297:Male; D015337:Multicenter Studies as Topic; D062645:Percutaneous Coronary Intervention / Q000009:adverse effects / Q000379:methods* / Q000401:mortality; D011379:Prognosis; D017534:Radial Artery; D016032:Randomized Controlled Trials as Topic; D018570:Risk Assessment; D015996:Survival Rate; D016896:Treatment Outcome; D014481:United States