The Radial Approach: Is This the Route to Take?

Abstract

The benefits of the transradial approach have clearly been demonstrated over the years in various studies. The reduced incidence of access site complications and early mobilization are some of the benefits making this technique popular with interventional cardiologists worldwide. With increasing experience and availability of dedicated equipment this technique is now been increasingly used for complex catheter interventions. However, there still remain some potential problems and complications with the transradial approach and it needs further research. The main purpose of this review is to highlight the benefits, complications, and potential problems with the transradial approach.

The Leipzig Prospective Vascular Ultrasound Registry in Radial Artery Catheterization

“…Routine radial artery ultrasound and the true rate of RAO. The rate of vascular access site complications after transradial coronary catheterization as monitored by vascular highresolution ultrasound examination was significantly higher in the present registry than expected from previous studies (27)(28)(29)(30). This finding implies that routine clinical radial pulse checks might be inaccurate and insensitive in detect-…”

Transradial Approach for Coronary Interventions: The New Gold Standard for Vascular Access?

“…Delayed recognition of a quiet but prolonged bleeding may lead to a large hematoma formation and sometimes to a compartment syndrome by pressure induced occlusion of the two major forearm arteries (ulnar and radial) (83,86).This severe complication must be treated by urgent fasciotomy and hematoma drainage to prevent ischemic injuries (Fig. 4).…”

Drug-Eluting Introducer Sheath Prevents Local Peripheral Complications

“…Insertion of an introducer sheath in the peripheral artery for percutaneous coronary angiography or percutaneous coronary intervention (PCI) may cause local complications at the access site, such as local arterial spasms, dissection, arterial stenosis, or occlusion, especially using the transradial approach (1)(2)(3). Most invasive cardiology centers traditionally use the femoral access for coronary angiography and PCI, but the transradial approach is becoming more popular due to economic considerations (early mobilization of the patients), and less local bleeding complications (4,5).…”