Korean Circ J.  2011 Jan;41(1):1-8. 10.4070/kcj.2011.41.1.1.

Transradial Approach as a Default Route in Coronary Artery Interventions

• Kim JY
• Yoon J

• KMID: 2225146
• DOI: http://doi.org/10.4070/kcj.2011.41.1.1

Abstract

Advances in percutaneous coronary intervention (PCI) and peri-procedural potent antithrombotic treatments during the past decade have dramatically improved the outcomes of ischemic heart disease. The femoral artery is the vascular route used in PCI in most catheterization labs. However, when the femoral artery is used as the approaching vessel, local hemorrhagic complication is not rare in the era of potent antithrombotics. Recent studies have suggested that peri-procedural bleeding complications after PCI are associated with increased short- and long-term morbidity and mortality. On the other hand, there has been growing interest in transradial PCI due to rare complications at the puncture site, patient conveniences, early discharge and shortened hospitalization periods. Furthermore, the indications of transradial PCI are expanding to the complex lesion subsets due to the miniaturization of devices used, improvement of devices and techniques, and accumulated experience with the use of transradial PCI. In this review, we discuss the data of transradial PCI as a potential default route in coronary artery interventions, as well as other issues that may raise concerns with transradial PCI.

Keyword

Angioplasty; Coronary arteries; Radial artery

MeSH Terms

Angioplasty
Catheterization
Catheters
Coronary Vessels
Femoral Artery
Glycosaminoglycans
Hand
Hemorrhage
Hospitalization
Humans
Miniaturization
Myocardial Ischemia
Percutaneous Coronary Intervention
Punctures
Radial Artery
Glycosaminoglycans

Figure

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  Fig. 1 Application of eutectic mixture of local anesthetic cream on radial artery puncture site.

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  Fig. 2 Procedural position of the right and left radial approaches for coronary interventions. A: left radial approach. B: right radial approach.

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  Fig. 3 Comparison of outer diameter (OD) between introducer sheath and sheathless guiding catheters (Adapted from reference 31 with authors' permission).

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