Transradial access for coronary diagnostic and interventional procedures: Consensus statement and recommendations for India

Abstract

Radial access for cardiac catheterization and intervention in India has been growing steadily over the last decade with favorable clinical outcomes. However, its usage by interventional cardiologists varies greatly among Indian operators and hospitals due to large geographic disparities in health care delivery systems and practice patterns. It also remains unclear whether the advantages, as well as limitations of transradial (TR) intervention (as reported in the western literature), are applicable to developing countries like India or not. An evidence-based review involving various facets of radial procedure for cardiac catheterization, including practical, patient-related and technical issues was conducted by an expert committee that formed a part of Advancing Complex CoronariES Sciences through TransRADIAL intervention (ACCESS RADIAL™) Advisory Board. Emerging challenges in redefining TR management based on evidence supporting practices were discussed to formulate these final recommendations through consensus.

Routine preprocedural ultrasound in palpation versus ultrasound guided radial access for cardiac catheterization

“…The radial artery (RA) has gained worldwide popularity as the preferred vascular access for cardiac catheterization procedures, 1–5 offering advantages such as reduced cost, bleeding, and complications, along with improved patient comfort and early ambulation, as supported by systematic reviews and meta‐analyses 6,7 . However mastering RA access can be challenging due to its steep learning curve 8 .…”

Femoral artery access site closure with perclose suture mediated device in coronary interventions

“… 6 In recent years, radial approach has gained popularity and has become the standard of care for routine PCI. 7 , 8 However, the choice of hardware is limited by the smaller size of radial artery in coronary interventions. 7 , 8 Large size of the femoral artery permits a wider range of hardware which might be required for the treatment of complex coronary lesions.…”

“… 7 , 8 However, the choice of hardware is limited by the smaller size of radial artery in coronary interventions. 7 , 8 Large size of the femoral artery permits a wider range of hardware which might be required for the treatment of complex coronary lesions. Traditionally femoral access site hemostasis is achieved by manual compression (MC) which is associated with various drawbacks such as patient discomfort during compression, vasovagal reaction, prolonged immobilization and bleeding.…”