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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72 results

Re-evolution in PCI: distal radial approach

18 May 2021 – From EuroPCR 2021

Watch this session presented by Gabriele Luigi Gasparini in order to learn about the advantages of using the distal radial approach for PCI, to discover the main considerations when using the distal radial, and to learn the key tips and tricks about the technique and the devices that...

Re-evolution in PCI: distal radial approach

PCR's Got Talent - Coronary and Other Cardiovascular Interventions

18 May 2021 – From EuroPCR 2021

Thanks to the abstracts gathered in this session, analyze the impact of repeat revascularization on 10-year mortality, study the randomized comparison between radial and femoral large-bore access in complex PCI, appraise the value of absolute flow measurement in patients with CAD, and much more!

PCR's Got Talent - Round 2: Coronary and Other Cardiovascular Interventions

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

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

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

Chapter 3 - Cannulation: guiding catheter choice (module 3.3)

22 Nov 2018

What kind and size of guiding catheter should you use for radial? I. Al Rashdan and H. Routledge share their insights and experience on selecting the appropriate guiding catheters for interventional procedures and optimising the support.

Guiding catheter choice

Chapter 3 - Cannulation: catheter choice for graft cannulation (module 3.2)

22 Nov 2018

Is radial suitable for patients with bypass grafts?

Catheter choice for graft cannulation

Chapter 3 - Cannulation: catheter choice for diagnostic angiogram (module 3.1)

22 Nov 2018

Is radial suitable for routine coronary diagnostic angiogram? In this module, Ibrahim Al Rashdan and Helen Routledge discuss using radial in these cases, including choosing the right catheter to minimise risk of failure.

Catheter choice for diagnostic angiogram

Radial Approach - Chapter 3: Cannulation

21 Nov 2018

Find out which catheters are the best for right radial approach, understand what is the ideal radial approach to cannulate Saphenous vein grafts and find out when more than 6F is needed?

Chapter 3: Cannulation

Catheter exchange with syringe technique

Additional resource: Chapter 3

Consult this video from the PCR edu course on Radial approach, which shows a catheter exchange with the syringe technique.

Catheter exchange with syringe technique

Radial arteriography

Additional resource: Chapter 2

Consult this video from the Clinique Pasteur - France on Radial approach, which shows a radial arteriography.

Radial arteriography

Patient preparation and local anaesthesia

Additional resource: Chapter 1

Consult this video from the PCR edu course on Radial approach, which shows how to prepare the patient for local anaesthesia.

Patient preparation and local anaesthesia