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

Comparison of stent geometry achieved by different side-branch ballooning techniques for bifurcation provisional stenting: the CRABBIS Trial

31 Mar 2025

Which ballooning technique is best after main vessel stenting in bifurcation PCI? This two-part study compares two key approaches: PKP (POT, kissing balloon inflation, final POT) and PSP (POT, isolated side branch dilation, final POT) to determine the optimal strategy.

Reviewer

Ali Nazmi Calik

Reviewer

Aaysha Cader
Comparison of stent geometry achieved by different side-branch ballooning techniques for bifurcation provisional stenting: the CRABBIS Trial

RCA hydraulic dissection: what to do?

06 Jan 2025

Any coronary intervention can be compromised by an iatrogenic hydraulic dissection: find out how to manage it with dissection stenting!

Pavel Somov

Author

Pavel Somov
Daniil Ylbashev

Author

Daniil Ylbashev
Shamil Chotchaev

Author

Shamil Chotchaev
Dmitriy Marchak

Author

Dmitriy Marchak
Arkhip Matusov

Author

Arkhip Matusov
Aleksei Litvinov

Author

Aleksei Litvinov
RCA hydrolic dissection: what to do?

Comparison of puncture success rate between distal radial access and transradial access in patients with ST-elevation myocardial infarction (DRAMI)

07 Nov 2024

Aaysha Cader provides her take on the DRAMI trial presented by Jun-Won Lee at TCT 2024 in Washington.

Author

Aaysha Cader
Comparison of puncture success rate between distal radial access and transradial access in patients with STEMI (DRAMI)

PCR @ TCT 2024 - Get the international perspective!

11 Oct 2024

Thanks to the contribution of a team of interventional cardiologists from around the globe, get the international perspective on Late-breaking Clinical Trials and Science released at TCT 2024 - check out the list below.

PCRonline @ TCT 2024 - get the international perspective!

Severely retroflexed calcified circumflex artery – Tackled with left distal radial approach!

30 May 2023

Calcified, retroflexed subtotal long occlusion of left circumflex into OM1 successfully intervened after lithotripsy via left distal radial (anatomical) snuffbox approach

Prasanna Sengodan

Author

Prasanna Sengodan
Severely retroflexed calcified circumflex artery – Tackled with left distal radial approach !

Radial artery: the best friend of double mesh carotid stents?

18 May 2023 – From EuroPCR 2023

In these slides, follow the steps described one by one to ensure the success of a high-quality radial procedure, and learn more about carotid artery stenting using radial approach, among others!

Radial artery: the best friend of double mesh carotid stents?

Complications of access site

18 May 2023 – From EuroPCR 2023

Discover a selection of cases involving access site complications: learn innovative strategies for reutilizing a chronically occluded radial access site prior to PCI, view acute compartment syndrome caused by radial artery spasm after PCI, explore the application of a special technique for intra-aortic balloon pump insertion in...

Complications of access site

Hostile vascular access for large catheters

17 May 2023 – From EuroPCR 2023

This case-based session will help you learn how to better manage ilio-vascular complications, either by radial or femoral access, and learn more about how to use your peripheral toolbox.

Hostile vascular access for large catheters

Challenging PCI in patients with complex coronary anatomy

17 May 2023 – From EuroPCR 2023

View complex cases including multivessel complex PCI using distal radial access in ACS and cardiogenic shock, complex SVG PCI, LM dissection in CHIP, and even more!

Challenging PCI in complex coronary anatomy

Complex aortic iliac interventions

17 May 2023 – From EuroPCR 2023

Consult this session to find out more about common iliac CTO PTA via radial approach, transbrachial intervention of bilateral common iliac arteries, shifting of thrombus across the aortoiliac bifurcation during iliac stenting, and much more!

Complex aortic iliac

Distal radial artery access for recanalization of radial artery occlusion and repeat intervention: a single centre experience

21 Dec 2022

This pilot study aimed to investigate the feasibility, safety, and efficacy (long-term patency) of the recanalization of chronic RAO via DRA7.

Reviewer

Aaysha Cader

Reviewer

Ali Nazmi Calik
Distal radial artery access for recanalization of radial artery occlusion and repeat intervention: a single centre experience

Distal vs conventional radial access for coronary angiography and/or intervention: a meta-analysis of randomized trials

30 Nov 2022

The present systematic review and meta-analysis by Ferrante et al aimed to provide a comprehensive quantitative analysis of the effects of DRA vs TRA, by pooling data from randomised controlled trials (RCT) comparing these two access sites when used for coronary angiography and/or percutaneous coronary intervention...

Reviewer

Aaysha Cader
Afonso Félix De Oliveira

Reviewer

Afonso Félix De Oliveira
Distal vs conventional radial access for coronary angiography and/or intervention: a meta-analysis of randomized trials

2-year outcomes of angiographic quantitative flow ratio-guided coronary interventions

23 Nov 2022

FAVOR-III China was an investigator-initiated, multicentre, randomised, blinded, sham-controlled trial comparing clinical outcomes of QFR versus angiography-guided strategies for the treatment of non-critical lesions in patients with stable or unstable angina, or MI, at least 72 hours prior to screening. The one-year results showed improved clinical...

Nicola Ryan

Reviewer

Nicola Ryan
2-year outcomes of angiographic quantitative flow ratio-guided coronary interventions

Radial approach in complex angioplasty: from the puncture to the haemostasis

31 Oct 2022

View this replay of a LIVE demonstration on mastering the essentials of a successful complex PCI by using radial approach, wiht operators J. Monségu and B. Faurie.

PCR Webinar on Demand: radial approach in complex angioplasty

Prevention of radial artery occlusion with rivaroxaban after transradial coronary procedures: The RIVARAD multicentric randomized trial

19 Sep 2022

Aaysha Cader interviews Rania Hammami, Principal Investigator of the RIVARAD trial. They discuss the design and results of the trial which was presented during #TCT2022.

RIVARAD is the first multicentric randomized trial with 30-day RAOs as the primary endpoint, which proved the efficacy of short-term use of...

Author

Aaysha Cader
Rania Hammami

Author

rania hammami
The RIVARAD Multicentric Randomized Trial: Prevention of Radial Artery Occlusion With Rivaroxaban After Transradial Coronary Procedures

UNIVERSAL: routine ultrasonography guidance for femoral vascular access for cardiac procedures - A randomized clinical Trial

19 Sep 2022

Ali Nazmi Calik provides his take on UNIVERSAL randomized clinical trial, which questioned whether routine ultrasonography guidance for CFA access for cardiac procedures reduces bleeding or vascular complications. This trial was presented by Sanjit S. Jolly during TCT 2022.

Author

Ali Nazmi Calik
UNIVERSAL: routine ultrasonography guidance for femoral vascular access for cardiac procedures - A randomized clinical Trial

RTC - Radial versus femoral access for coronary procedures

29 Aug 2022

Thirty years after the first radial access interventional coronary procedure the RTC trial provides evidence that radial access for coronary angiography or PCI is associated with lower risks of all-cause death and bleeding compared with femoral access. Mirvat Alasnag interviews Giuseppe Gargiulo regarding the methodology and...

Dr. Mirvat Alasnag

Author

Mirvat Alasnag
Giuseppe Gargiulo

Author

Giuseppe Gargiulo
RTC - Radial versus femoral access for coronary procedures

Radial access for chronic total occlusion percutaneous coronary intervention: insights from the PROGRESS‐CTO registry

27 Jul 2022

This analysis of the large multinational Prospective Global Registry for the Study of Chronic Total Occlusion Intervention (PROGRESS‐CTO) registry1 examined prevalence, temporal trends, and clinical outcomes of radial versus femoral access in CTO PCI.

Reviewer

Aaysha Cader
Saidur Rahman Khan

Reviewer

Saidur Rahman Khan
Radial access for chronic total occlusion percutaneous coronary intervention: Insights from the PROGRESS‐CTO registry

Evaluation of the incidence of radial artery occlusion using different introducer sheaths and hemostasis techniques

19 Jul 2022

This retrospective observational study was undertaken in patients referred for transradial coronary angiography (CA) or PCI to assess the impact of sheath sizes and haemostasis techniques on RAO incidence.

Reviewer

Aaysha Cader
Radial versus femoral access in ACS patients undergoing complex PCI is associated with consistent bleeding benefit and no excess of risk

Radial versus femoral access in ACS patients undergoing complex PCI is associated with consistent bleeding benefit and no excess of risk

18 Jul 2022

In this paper, the authors investigated the comparative efficacy and safety of TRA versus TFA in ACS patients undergoing complex PCI in the Minimizing Adverse Haemorrhagic Events by TRansradial Access Site and Systemic Implementation of angioX (MATRIX)-Access trial1.

Reviewer

Aaysha Cader

Reviewer

Ali Nazmi Calik
Radial versus femoral access in ACS patients undergoing complex PCI is associated with consistent bleeding benefit and no excess of risk