Radial Catheterization Advantages
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Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1]; Associate Editor-In-Chief: Varun Kumar, M.B.B.S.; Lakshmi Gopalakrishnan, M.B.B.S.
Overview
Advantages of the Radial Approach to Cardiac Catheterization
Reduced Bleeding
There are increasing evidences showing that major bleeding is independently associated with increased risk for mortality and ischemic events among patients with acute coronary syndrome undergoing percutaneous coronary intervention.[1][2]
- Early patient ambulation[3]
- Greater patient satisfaction
- Absence of retroperitoneal hematomas, femoral pseudo aneurysms, arteriovenous fistulas
- Reduced length of stay[3]
- Improved access in the obese patient
- Dual blood supply which limits the potential for limb threatening ischemia
- Advantageous for patients with severe occlusive aortoiliac disease
- Advantageous for patients with back pain, obesity, congestive heart failure who have difficulty laying flat on back.
- Less likelihood of local nerve injury
- Radial artery is easily compressible
In a meta-analysis of publications from 1980 to 2008, radial artery catheterization was associated with a 73% relative risk reduction in the risk of major bleeding (2.3% vs 0.05%, p<0.001) compared to femoral access. While the risk of the composite endpoint of death, myocardial infarction (MI) and stroke tended to be less frequent among patients undergoing radial artery catheterization (3.8% vs 2.5%, p = .058), there was no difference in mortality alone. Radial artery access also was associated with a 0.4% reduction in length of stay (p=0.001).[4]
References
- ↑ Eikelboom, JW.; Mehta, SR.; Anand, SS.; Xie, C.; Fox, KA.; Yusuf, S. (2006). "Adverse impact of bleeding on prognosis in patients with acute coronary syndromes". Circulation. 114 (8): 774–82. doi:10.1161/CIRCULATIONAHA.106.612812. PMID 16908769. Unknown parameter
|month=ignored (help) - ↑ Rao, SV.; O'Grady, K.; Pieper, KS.; Granger, CB.; Newby, LK.; Van de Werf, F.; Mahaffey, KW.; Califf, RM.; Harrington, RA. (2005). "Impact of bleeding severity on clinical outcomes among patients with acute coronary syndromes". Am J Cardiol. 96 (9): 1200–6. doi:10.1016/j.amjcard.2005.06.056. PMID 16253582. Unknown parameter
|month=ignored (help) - ↑ 3.0 3.1 Suleiman K, Feldman A, Ilan-Bushari L, Turgeman Y (2008). "[Transradial diagnostic and interventional cardiac catheterization in daily practice: advantages, efficacy and safety]". Harefuah. 147 (5): 388–93, 479. PMID 18770958.
- ↑ Jolly SS, Amlani S, Hamon M, Yusuf S, Mehta SR (2009). "Radial versus femoral access for coronary angiography or intervention and the impact on major bleeding and ischemic events: a systematic review and meta-analysis of randomized trials". American Heart Journal. 157 (1): 132–40. doi:10.1016/j.ahj.2008.08.023. PMID 19081409. Retrieved 2010-02-23. Unknown parameter
|month=ignored (help)