Vascular access: time development and contemporary practice

Abstract

The choice of the vascular access for coronary angiography or angioplasty is a function of the operator´s experience, of the presence of arterial pulse at the chosen site, and of the clinical status of the patient. The femoral approach should still be preferable in cases of higher angiographic complexity that require large-bore guide catheters, while radial access should be the approach for elective coronary angiography and acute myocardial infarction, taking into consideration the reduction in overall events. When the standard radial approach is not possible, ulnar and distal radial access are appropriate alternatives.