Controversies in complex percutaneous coronary intervention: radial versus femoral

Abstract

Evolution in the technology used in the cardiac catheterization laboratory has permitted a migration from the femoral to radial artery access for many interventional procedures while concurrently improving outcomes. As a disruptive technology, transradial access has been associated with several controversies including a dichotomous relationship with femoral access. Areas covered: Several different patient subsets along with perceived technical challenges in interventional cardiology are reviewed with regard to the issue of access site. Evolving technological improvements germane to transradial techniques are also discussed as garnered from the literature of recent clinical trials and reports. Expert commentary: Radial techniques have been enhanced by newer technology and the spread of knowledge. Fusion of radial techniques with those of the femoral approach is evolving into a unifying concept of using the access that is most appropriate for the patient. No one access technique can cover all clinical subsets of patients. There is a need for complimentary access skillsets for even the most advanced cardiovascular technology used in the cardiac catheterization laboratory if the patients' outcomes are to be idealized.

Predictive value of combining the level of fibrinogen and antithrombin III for contrast‑induced nephropathy in coronary artery disease patients undergoing percutaneous coronary intervention

“…For emergency coronary interventional procedures, physiological (0.9%) saline was administered intravenously at a rate of 1 ml/kg/h for 12 h following contrast exposure. Coronary angiography and PCI were performed by interventional cardiologists, according to the standard clinical practice using the radial or femoral approach (9). All patients were administered aspirin (loading dose, 300 mg) and clopidogrel (loading dose, 300 mg) or ticagrelor (180 mg) upon presentation, and were subsequently administered a daily dose of aspirin (100 mg/day) and clopidogrel (75 mg/day) or ticagrelor (90 mg/day).…”