Comparing radial and femoral access for coronary angiography and interventions

Abstract

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.

Comparison of X-Ray Duration and Contrast Agent Amount in Coronary Angiography Using Radial and Femoral Access in Bandar Abbas Angiography Center in 2017

“…Angiography through radial access takes more time than femoral access (20)(21)(22). Moreover, consistency in using this access type requires more skill on the part of the doctor.…”

Temel Angiyografi: Arter Girim Yollari ve Malzeme Tanitimi

“…Bilekte radial arter girişi tanısal ve girişimsel işlemlerde özellikle kardiyologlar tarafından giderek artan sıklıkta kullanılan bir yaklaşım şekli haline gelmiştir [8]. Ulnar arter eli yeteri kadar besliyorsa radial giriş daha güvenli olarak kullanılabilir.…”

A randomised controlled study of standard versus accelerated deflation of the Terumo radial band haemostasis device after transradial diagnostic cardiac catheterisation

“…2 Radial access is associated with fewer access-site complications and does not require immobilisation after the procedure. [3][4][5][6][7][8][9] Even in patients with acute coronary syndromes undergoing invasive management, radial access reduces net adverse clinical events through a reduction in major bleeding and all-cause mortality. 2,10 Vascular closure after a radial approach can be obtained by using a pressure bandage or an external pressure device such as, for example, the Terumo radial (TR) band.…”