DOI QR코드

DOI QR Code

Transradial Approach as a Default Route in Coronary Artery Interventions

  • Kim, Jang-Young (Divison of Cardiology, Department of Internal Medicine, Wonju College of Medicine, Yonsei University) ;
  • Yoon, Jung-Han (Divison of Cardiology, Department of Internal Medicine, Wonju College of Medicine, Yonsei University)
  • Published : 2011.01.30

Abstract

Advances in percutaneous coronary intervention (PCI) and peri-procedural potent antithrombotic treatments during the past decade have dramatically improved the outcomes of ischemic heart disease. The femoral artery is the vascular route used in PCI in most catheterization labs. However, when the femoral artery is used as the approaching vessel, local hemorrhagic complication is not rare in the era of potent antithrombotics. Recent studies have suggested that peri-procedural bleeding complications after PCI are associated with increased short- and long-term morbidity and mortality. On the other hand, there has been growing interest in transradial PCI due to rare complications at the puncture site, patient conveniences, early disch-arge and shortened hospitalization periods. Furthermore, the indications of transradial PCI are expanding to the complex lesion subsets due to the miniaturization of devices used, improvement of devices and techniques, and accumulated experience with the use of transradial PCI. In this review, we discuss the data of transradial PCI as a potential default route in coronary artery interventions, as well as other issues that may raise concerns with transradial PCI.

Keywords

References

  1. Agostoni P, Biondi-Zoccai GG, de Benedictis ML, et al. Radial versus femoral approach for percutaneous coronary diagnostic and interventional procedures: systematic overview and meta-analysis of randomiz-ed trials. J Am Coll Cardiol 2004;44:349-56. https://doi.org/10.1016/j.jacc.2004.04.034
  2. Yoon J, Lee SH, Lee HH, et al. Usefulness of trans-radial coronary an-giography in Wonju. Korean Circ J 1998;28:1670-6.
  3. Yoon J, Lee SH, Kim JY, et al. The experience of trans-radial coronary intervention in Wonju. Korean Circ J 1998;28:1443-51.
  4. Doyle BJ, Ting HH, Bell MR, et al. Major femoral bleeding complications after percutaneous coronary intervention: incidence, predictors, and impact on long-term survival among 17,901 patients treated at the Mayo Clinic from 1994 to 2005. JACC Cardiovasc Interv 2008;1:202-9. https://doi.org/10.1016/j.jcin.2007.12.006
  5. Yatskar L, Selzer F, Feit F, et al. Access site hematoma requiring blood transfusion predicts mortality in patients undergoing percutaneous coronary intervention: data from the National Heart, Lung, and Blood Institute Dynamic Registry. Catheter Cardiovasc Interv 2007;69:961-6. https://doi.org/10.1002/ccd.21087
  6. Jolly S, Amlani S, Hamon M, Yusuf S, Mehta SR. Radial versus femoral access for coronary angiography or intervention and the impact on major bleeding and ischemic events: a systematic review and meta-an-alysis of randomized trials. Am Heart J 2009;157:132-40. https://doi.org/10.1016/j.ahj.2008.08.023
  7. Rao SV, Ou FS, Wang TY, et al. Trends in the prevalence and outcomes of radial and femoral approaches to percutaneous coronary in-tervention: a report from the National Cardiovascular Data Registry. JACC Cardiovasc Interv 2008;1:379-86. https://doi.org/10.1016/j.jcin.2008.05.007
  8. Vorobcsuk A, Konyi A, Aradi D, et al. Transradial versus transfemoral percutaneous coronary intervention in acute myocardial infarction: systematic overview and meta-analysis. Am Heart J 2009;158:814-21. https://doi.org/10.1016/j.ahj.2009.08.022
  9. Chase AJ, Fretz EB, Warburton WP, et al. Association of the arterial ac-cess site at angioplasty with transfusion and mortality: the M.O.R.T.A.L study (Mortality benefit Of Reduced Transfusion after percutaneous coronary intervention via the Arm or Leg). Heart 2008;94:1019-25. https://doi.org/10.1136/hrt.2007.136390
  10. Cooper CJ, El-Shiekh RA, Cohen DJ, et al. Effect of transradial access on quality of life and cost of cardiac catheterization: a randomized comparison. Am Heart J 1999;138:430-6. https://doi.org/10.1016/S0002-8703(99)70143-2
  11. Amoroso G, Laarman GJ, Kiemeneij F. Overview of the transradial ap-proach in percutaneous coronary intervention. J Cardiovasc Med (Ha-gerstown) 2007;8:230-7. https://doi.org/10.2459/01.JCM.0000263494.10865.0f
  12. Spaulding C, Lefevre T, Funck F, et al. Left radial approach for coronary angiography: results of a prospective study. Cathet Cardiovasc Diagn 1996;39:365-70. https://doi.org/10.1002/(SICI)1097-0304(199612)39:4<365::AID-CCD8>3.0.CO;2-B
  13. Kim JY, Lee SH, Choe HM, Yoo BS, Yoon J, Choe KH. The feasibility of percutaneous transradial coronary intervention for chronic total oc-clusion. Yonsei Med J 2006;47:680-7. https://doi.org/10.3349/ymj.2006.47.5.680
  14. Rathore S, Hakeem A, Pauriah M, Roberts E, Beaumont A, Morris JL. A comparison of the transradial and the transfemoral approach in ch-ronic total occlusion percutaneous coronary intervention. Catheter Car-diovasc Interv 2009;73:883-7. https://doi.org/10.1002/ccd.21922
  15. Saito S, Tanaka S, Hiroe Y, et al. Comparative study on transradial ap-proach vs. transfemoral approach in primary stent implantation for pa-tients with acute myocardial infarction: results of the test for myocardial infarction by prospective unicenter randomization for access sites (TEMPURA) trial. Catheter Cardiovasc Interv 2003;59:26-33. https://doi.org/10.1002/ccd.10493
  16. Kim JY, Yoon J, Jung HS, et al. Feasibility of the radial artery as a vas-cular access route in performing primary percutaneous coronary inter-vention. Yonsei Med J 2005;46:503-10. https://doi.org/10.3349/ymj.2005.46.4.503
  17. Yang YJ, Xu B, Chen JL, et al. Comparison of immediate and follow up results between transradial and transfemoral approach for percutaneous coroanry intervention in true bifurcational lesions. Chin Med J 2007;120:539-44.
  18. Kessel DO, Robertson I, Taylor EJ, Patel JV. Renal stenting from the radial artery: a novel approach. Cardiovasc Intervent Radiol 2003;26:146-9.
  19. Sanghvi K, Kurian D, Coppola J. Transradial intervention of iliac and superficial femoral artery disease is feasible. J Interv Cardiol 2008;21:385-7. https://doi.org/10.1111/j.1540-8183.2008.00384.x
  20. Bertrand OF, Rao SV, Pancholy S, et al. Transradial approach for coro-nary angiography and interventions: results of the first international transradial practice survey. JACC Cardiovasc Interv 2010;3:1022-31. https://doi.org/10.1016/j.jcin.2010.07.013
  21. Gajraj NM, Pennant JH, Watcha MF. Eutectic mixture of local analgesics (EMLA) cream. Anesth Analg 1994;78:574-83.
  22. Kim JY, Yoon J, Yoo BS, Lee SH, Choe KH. The effect of a eutectic mixture of local anesthetic cream on wrist pain during transradial co-ronary procedures. J Invasive Cardiol 2007;19:6-9.
  23. Yoo BS, Yoon J, Ko JY, et al. Anatomical consideration of the radial artery for transradial coronary procedures: arterial diameter, branching anomaly and vessel tortuosity. Int J Cardiol 2005;101:421-7. https://doi.org/10.1016/j.ijcard.2004.03.061
  24. Lin YJ, Chu CC, Tsai CW. Acute compartment syndrome after transradial coronary angioplasty. Int J Cardiol 2004;97:311. https://doi.org/10.1016/j.ijcard.2003.05.052
  25. Stella PR, Kiemeneij F, Laarman GJ, Odekerken D, Slagboom T, van der Wieken R. Incidence and outcome of radial artery occlusion follow-ing transradial artery coronary angioplasty. Cathet Cardiovasc Diagn 1997;40:156-8. https://doi.org/10.1002/(SICI)1097-0304(199702)40:2<156::AID-CCD7>3.0.CO;2-A
  26. Pancholy SB. Comparison of the effect of intra-arterial versus intravenous heparin on radial artery occlusion after transradial catheterization. Am J Cardiol 2009;104:1083-5. https://doi.org/10.1016/j.amjcard.2009.05.057
  27. Kim JY, Yoon J, Jung IH, et al. Transradial coronary intervention: comparison of the left and right radial artery approach. Korean Circ J 2006;36:780-5. https://doi.org/10.4070/kcj.2006.36.12.780
  28. Sciahbasi A, Romagnoli E, Burzotta F, et al. Transradial approach (left vs right) and procedural times during percutaneous coronary procedures: TALENT study. Am Heart J 2011;161:172-9. https://doi.org/10.1016/j.ahj.2010.10.003
  29. Cha KS, Kim MH, Kim HJ. Prevalence and clinical predictors of severe tortuosity of right subclavian artery in patients undergoing trans-radial coronary angiography. Am J Cardiol 2003;92:1220-2. https://doi.org/10.1016/j.amjcard.2003.07.038
  30. Dahm JB, Vogelgesang D, Hummel A, Stuudt A, Volzke H, Felix SB. A randomized trial of 5 vs 6 French transradial percutaneous coronary interventions. Catheter Cardiovasc Interv 2002;57:172-6. https://doi.org/10.1002/ccd.10321
  31. Youn YJ, Yoon J, Sung JK, Kim JY. Feasibility of transradial coronary intervention using the sheathless guiding catheter in patients with sm-all radial artery. Korean Circ J 2011; In press.
  32. Mamas MA, Fath-Ordoubadi F, Fraser DG. Atraumatic complex trans-radial intervention using large bore sheathless guide catheter. Catheter Cardiovasc Interv 2008;72:357-64. https://doi.org/10.1002/ccd.21637
  33. Liang M, Puri A, Linder R. Transradial simultaneous kissing stenting (SKS) with sheathless access. Catheter Cardiovasc Interv 2010;75:222-4. https://doi.org/10.1002/ccd.22236
  34. Nikolsky E, Mehran R, Dangas G, et al. Development and validation of a prognostic risk score for major bleeding in patients undergoing per-cutaneous coronary intervention via the femoral approach. Eur Heart J 2007;28:1936-45. https://doi.org/10.1093/eurheartj/ehm194
  35. Eikelboom JW, Mehta SR, Anand SS, Xie C, Fox KA, Yusuf S. Adverse impact of bleeding on prognosis in patients with acute coronary syndromes. Circulation 2006;114:774-82. https://doi.org/10.1161/CIRCULATIONAHA.106.612812
  36. Saito S, Tanaka S, Hiroe Y, et al. Angioplasty for chronic total occlusion by using tapered-tip guidewires. Catheter Cardiovasc Interv 2003;59:305-11. https://doi.org/10.1002/ccd.10505

Cited by

  1. Evaluation of radial artery atherosclerosis by intravascular ultrasound. vol.64, pp.1, 2013, https://doi.org/10.1177/0003319712437030
  2. A Twist in the Transradial Coronary Catheterisation vol.23, pp.3, 2011, https://doi.org/10.1016/j.hlc.2013.09.006
  3. Effect of percutaneous coronary intervention on heart rate recovery in patients with coronary artery disease vol.26, pp.5, 2011, https://doi.org/10.1097/mca.0000000000000264
  4. Coronary Angiography Safety between Transradial and Transfemoral Access vol.2016, pp.None, 2011, https://doi.org/10.1155/2016/4013843
  5. Transradial approach for coronary angiography and percutaneos coronary intervention: personal experience vol.71, pp.1, 2019, https://doi.org/10.1186/s43044-019-0006-2
  6. Radial Access for Coronary Angiography Carries Fewer Complications Compared with Femoral Access: A Meta-Analysis of Randomized Controlled Trials vol.10, pp.10, 2011, https://doi.org/10.3390/jcm10102163