SCAI Addresses Transradial Access for Coronary and Peripheral Interventions

November 15, 2011—The Society for Cardiovascular Angiography and Interventions (SCAI) announced the publication of a paper that examines the value, technique, and best practices for performing angioplasty via the radial artery in the wrist. Robert P. Caputo, MD, et al published the paper in SCAI's Catheterization and Cardiovascular Interventions (2011;78:823–839). The paper provides guidance on patient selection, preprocedural preparation, determining which artery in the wrist to use, preventing and overcoming complications, and training and credentialing.

For treatments related to peripheral artery disease, the paper surveys literature, devices, and techniques for transradial access in carotid artery interventions, vertebrobasilar interventions, subclavian and innominate artery interventions, renal artery interventions, as well as for endovascular management of celiac, mesenteric, and superficial femoral arterial systems. For treatments related to coronary artery disease, the paper provides an overview of transradial access in percutaneous coronary interventions, primary percutaneous coronary interventions, vein graft angiography, sheath removal and recovery, and right heart catheterizations.

“This is the first time the procedure in its entirety has been addressed in a single document,” commented Dr. Caputo. “The document offers a valuable resource for interventional cardiologists before they start using the procedure. It's a one-stop source for transradial coronary intervention.”

As summarized by SCAI, data analyzed by Dr. Caputo and colleagues show fewer risks and complications associated with transradial interventions. Unlike other access sites, the radial approach provides easy compressibility and distance from major vessels and nerves. Compared with the femoral approach, it has achieved significant reductions in bleeding and access site complications. The document notes that fewer complications can impact the length of hospital stays, potentially reducing costs and improving clinical outcomes. The paper also states that patient preference leans toward radial access due to increased functioning, less discomfort, and for some patients the option of same-day discharge from the hospital.

According to SCAI, there has been an increase in transradial coronary interventions both nationally and globally, outpacing femoral access in some countries. In the United States, there has been an 8% to 10% increase in the use of transradial coronary interventions, which is a trend that is expected to continue.

SCAI President Christopher J. White, MD, stated, “Transradial access has great promise for improving patient comfort and outcomes. Transradial coronary intervention is a good example of our efforts to improve quality of patient care by offering new options for patients. These innovative advancements improve the overall patient experience on multiple levels—comfort, safety, function, and cost.”