Radial approach

Learn the effectiveness and safety of transradial artery access for cardiac coronary catheterisation or peripheral intervention

The radial artery has become the primary alternative to femoral artery access because of the benefit in term of bleeding, its superficial location and easy compressibility and low risk of ischaemia. Radial artery access is used by interventional cardiologists with the wrist as the entry point for the catheter.

The transradial approach for coronary angiography and angioplasty, while not new, is gaining momentum as a viable alternative to the transfemoral approach. While technically it may have some challenges, there are significant benefits including reduced patient discomfort, improved time to ambulation, reduction in costs, and reduction in potentially life-threatening complications.

This section will help you to master the essentials of successful PCI using the radial approach, provide you with information about clinical case strategies and the limitations of the radial approach.

Make sure you stay up to date with what's new in the world of #Radialfirst and #DistalRadial by following @PCRonline!

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82 results

Distal radial approach to reaccess and recanalize the occluded radial artery

30 Apr 2021

A 56-year-old man was re-admitted with chest pain. He had been hospitalized 2 weeks before because of MI, was suffering from metastatic carcinoma with recurrent PTE, and was on long-term subcutaneous heparin...

Distal radial approach to reaccess and recanalize the occluded radial artery

Complications during radial access

14 Apr 2021 – From EuroPCR 2021

Watch this session to find out more about a life-threatening complication of radial access, together with a rare complication highlighting the need to respect the radial artery.

EuroPCR 2021 Complications during radial access

EAPCI-PCR Fellows Course 2021 - Coronary track: Radial approach/Coronary angiogram

14 Apr 2021 – From EuroPCR 2021

The EAPCI-PCR Fellows Course is a project supported by the New Initiatives For Young Interventionalists Committee (NIFYI) and PCR NextGen, and is intended for practitioners at the beginning of their careers. Education and networking are at the core of the building of future careers powered by...

EAPCI-PCR Fellows Course - Coronary track: Radial approach/Coronary angiogram

Characteristics and outcomes of patients with history of CABG undergoing cardiac catheterization via the radial versus femoral approach

07 Apr 2021

The aims of this study were to examine clinical and procedural outcomes in post-CABG patients who underwent diagnostic catheterization and/or PCI via the radial or femoral approach.

Reviewer

Salvatore Brugaletta
Outcomes for radial versus femoral access among 1,279,058 procedures

Radial artery dilatation to improve access and lower complications during coronary angiography: the RADIAL trial

06 Apr 2021

The RADIAL study sought to explore the impact of prolonged occlusion flow-mediated dilatation (PO-FMD) in improving radial artery cannulation success.

Reviewer

Ali Nazmi Calik
Radial artery dilatation to improve access and lower complications during coronary angiography: the RADIAL trial

Distal radial artery approach to prevent radial artery occlusion trial

16 Apr 2021

The aim of this study was to compare the rate of proximal RAO with Doppler ultrasound (DUS) between distal and conventional radial access 24 h after a transradial coronary procedure.

Elad Asher

Reviewer

Elad Asher
Distal radial artery approach to prevent radial artery occlusion trial

How to solve refractory catheter kink in humeral artery during right radial coronary angiogram?

02 Apr 2021

Consult this Twitter case on the management of a persistent kinking of diagnostic catheter (JR4) after failure of usual techniques.

Grégoire Range

Author

Grégoire Range
How to solve refractory catheter kink in humeral artery during coronary angiogram with right radial approach?

Radial sheath fracture removed surgically after severe radial spasm

19 Mar 2021

Radial artery spasm is inevitable when dealing with small caliber one, especially in calcified radial artery. We describe a case in which radial sheath broke due to severe radial spasm and successfully removed by vascular surgical extraction.

Aly Tohamy

Author

Aly Tohamy
Radial sheath fracture removed surgically after severe radial spasm

Overcoming the 360 degree radial artery loop

17 Mar 2021

A 77-year-old man was admitted for an elective diagnostic coronary angiogram. Following insertion of a 6Fr sheath into the distal right radial artery, a radial angiogram showed complete 360 degree radial artery loop...

Overcoming the 360 degree radial artery loop

How to treat a distal coronary perforation?

05 Jan 2021

View this case of a 60-year-old female patient who was scheduled for PCI of the LAD, during which perforation occurred. What would be your treatment options?

Pham Quoc Bang

Author

Pham Quoc Bang
To treat distal coronary perforation

Undilatable calcific lesion even after rotational atherectomy

19 Dec 2019

View this very uncommon case in which balloons do not expand even after a rather aggressive rotational atherectomy: a 43-year-old male with hypertension, smoking and dyslipidemia presents with total occlusion of proximal left anterior descending artery with fresh thrombus...

Author

Flavio Luciano Ribichini
Concetta Mammone

Author

Concetta Mammone
Undilatable calcific lesion even after rotational atherectomy

BAT technique to the rescue during primary PCI

15 Jul 2019

Consult this Twitter Case concerning a 61-year-old man with a diagnosis of anterior STEMI who was immediately transferred to the cath lab for primary percutaneous coronary intervention...

Ricardo Kiamco

Author

Ricardo Kiamco
BAT technique to the rescue during primary PCI

Left main and complex bifurcation stenting via transradial approaches

04 Jul 2019 – From AICT-AsiaPCR 2019

Consult this session to learn more about the best treatment options for patients presenting with left main and complex bifurcations lesions, and gain insights on vascular healing and latest clinical outcomes with Ultimaster DES.

Left main and complex bifurcation stenting via transradial approaches

#radialfirst: cases, complications and more

24 May 2019 – From EuroPCR 2019

Consult this session on radial artery clinical cases, to learn more about this approach and how to cope with the potential complications.

#radialfirst: cases, complications and more

Trouble on the way: radial artery challenges

23 May 2019 – From EuroPCR 2019

Consult this session to discover compelling clinical cases regarding radial artery challenges, such as the percutaneous retrieval of a kinked catheter in the right subclavian artery, proximal and distal compression for treatment of radial artery pseudo-aneurysm, and more!

Trouble on the way: radial artery challenges

ACC 2019 Day 3: SAFARI-STEMI, STOPDAPT-2, SMART-CHOICE and more

19 Mar 2019

Mirvat Al Asnag reported live on major late-breaking trials presented at ACC 2019 in New Orleans: SAFARI-STEMI, STOPDAPT-2, SMART-CHOICE, TREAT and more

Dr. Mirvat Alasnag

Author

Mirvat Alasnag
ACC 2019 Day 3: SAFARI-STEMI, STOPDAPT-2, SMART-CHOICE and more

Radial approach: the essentials

15 Mar 2019

PCR edu online

Radial access is generally very simple, but sometimes it can be more challenging. Watch these videos to become more confident and improve your performance in this technique. The course follows a logical sequence, from patient selection, to puncture and navigation, to ostia vessel cannulation. Consult...

Radial approach: the essentials

Transradial balloon aortic valvuloplasty

23 Jan 2019

Balloon aortic valvuloplasty (BAV) may still have a role in the transcatheter aortic valve implantation (TAVI) era. Trans-radial BAV, herein described, has been developed to reduce peripheral complications and make the procedure safer.

Author

Francesco Saia
Trans-radial balloon aortic valvuloplasty

Transradial left main PCI is safe and effective

02 Jan 2019

This multiple large randomised trials includes more than 18,000 patients comparing transradial vs. transfemoral access for coronary intervention that have shown that transradial access improves outcomes including major vascular complications, bleeding and mortality!

Authors :

S. S. Jolly, M. Valgimigli
Transradial left main PCI is safe and effective

Radial versus femoral artery access in patients undergoing PCI for left main coronary artery disease: analysis from the EXCEL trial

02 Jan 2019

Read this EuroIntervention article by Shmuel Chen et al. on the procedural characteristics of transradial access (TRA) versus transfemoral access (TFA) in patients who were treated with PCI for left main coronary artery disease.

Authors :

Shmuel Chen, Björn Redfors, Yangbo Liu, Ori Ben-Yehuda, Marie-Claude Morice, Martin B. Leon, David E. Kandzari, Roxana Mehran, Nicholas J. Lembo, Adrian P. Banning, Béla Merkely, Arie Pieter Kappetein, Joseph F. Sabik, Patrick W. Serruys, Gregg W. Stone
Analysis from the EXCEL trial