Does Transradial Approach become a Golden Standard for Percutaneous Coronary Interventions?

Abstract

Transradial approach (TRA) in percutaneous coronary interventions (PCI) today becomes widely accepted and practiced procedure worldwide. TRA for PCI is safe and fast growing alternative to transfemoral approach (TFA) in many clinical settings and it is the desirable vascular access for most highly experienced operators. Although the TRA provides many clinical and economical benefits, may be the most important advantage is a decreased rate of vascular access-related bleeding complications after PCI. TRA is associated with certain learning curve and generally it requires higher technical skills of the operator compared to TFA. If progressive use of TRA for PCI continues to rise over next several years, we can expect soon TRA to become a golden standard for PCI procedures. Radial artery occlusion (RAO) remains one of the possible consequences of TRA especially if repeated PCI is performed via the same radial artery. TRA is feasible and effective approach for PCI in vast majority of patients and its value becomes especially important in high risk subset of patients including STEMI patients. The main advantages over TFA include lower rate of access-site bleeding complications, lower mortality in STE-ACS, better patient comfort, early ambulation and shorter in-hospital stay and they are clearly documented today.