A decade ago, radial artery access for primary percutaneous coronary intervention
(PCI) in ST elevation myocardial infarction (STEMI) represented less than 10% of procedures
undertaken worldwide [
[1]
], with transfemoral access the most common route of procedural access. The landmark
Radial Vs femorAL access for coronary angiography and intervention in acute coronary
syndrome (ACS) patients (RIVAL) study, published in 2011, was instrumental in changing
this paradigm of care. RIVAL demonstrated that radial access was associated with a
significantly lower rate of vascular complications as compared to femoral access [
- Arzamendi D.
- Ly H.Q.
- Tanguay J.F.
- Chan M.Y.
- Chevallereau P.
- Gallo R.
- et al.
Effect on bleeding, time to revascularization, and one-year clinical outcomes of the
radial approach during primary percutaneous coronary intervention in patients with
ST-segment elevation myocardial infarction.
Am J Cardiol. 2010; 106: 148-154
[2]
], a finding that has been subsequently confirmed in more recent studies demonstrating
less bleeding and reduced mortality [
[3]
,
- Mason P.J.
- Shah B.
- Tamis-Holland J.E.
- Bittl J.A.
- Cohen M.G.
- Safirstein J.
- et al.
An Update on radial artery access and best practices for transradial coronary angiography
and intervention in acute coronary syndrome: a scientific statement from the American
Heart Association.
Circ Cardiovasc Interv. 2018; 11e000035
[4]
]. The radial artery has thereafter gradually become the preferred mode of access
for coronary angiography and angioplasty. In recognition of this, a 2018 Scientific
Statement from the American Heart Association proposed a “radial-first” strategy in
the United States for ACS patients. Current contemporary data reaffirms this shift
with radial artery access used in up to 83% of ST-segment elevation myocardial infarction
(STEMI) cases [
- Valgimigli M.
- Frigoli E.
- Leonardi S.
- Vranckx P.
- Rothenbühler M.
- Tebaldi M.
- et al.
Radial versus femoral access and bivalirudin versus unfractionated heparin in invasively
managed patients with acute coronary syndrome (MATRIX): final 1-year results of a
multicentre, randomised controlled trial.
Lancet. 2018; 392: 835-848
[5]
].Key Words
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References
- Effect on bleeding, time to revascularization, and one-year clinical outcomes of the radial approach during primary percutaneous coronary intervention in patients with ST-segment elevation myocardial infarction.Am J Cardiol. 2010; 106: 148-154
- Radial versus femoral access for coronary angiography and intervention in patients with acute coronary syndromes (RIVAL): a randomised, parallel group, multicentre trial.Lancet. 2011; 377: 1409-1420
- An Update on radial artery access and best practices for transradial coronary angiography and intervention in acute coronary syndrome: a scientific statement from the American Heart Association.Circ Cardiovasc Interv. 2018; 11e000035
- Radial versus femoral access and bivalirudin versus unfractionated heparin in invasively managed patients with acute coronary syndrome (MATRIX): final 1-year results of a multicentre, randomised controlled trial.Lancet. 2018; 392: 835-848
- Predictors of radial to femoral artery crossover during primary percutaneous coronary intervention: a systematic review and meta-analysis.Heart Lung Circ. 2021; 30: S318
- Predictors of radial to femoral artery access crossover during primary percutaneous coronary intervention for ST-elevation myocardial infarction.Heart Lung Circ. 2022; 31: 985-992
- Access-site crossover in patients with acute coronary syndrome undergoing invasive management.JACC Cardiovasc Interv. 2021; 14: 361-373
- Effect of ischemia duration and door-to-balloon time on myocardial perfusion in ST-segment elevation myocardial infarction: an analysis from HORIZONS-AMI trial (Harmonizing outcomes with revascularization and stents in acute myocardial infarction). JACC Cardiovasc Interv. 2015;8:1966-1974. Erratum in.JACC Cardiovasc Interv. 2016; 9: 516
- Radial versus femoral approach in women undergoing coronary angiography: a meta-analysis of randomized controlled t rials.J Invasive Cardiol. 2019; 31: 335-340
- Radial artery access is underutilized in women undergoing PCI despite potential benefits: Mayo Clinic PCI Registry.Catheter Cardiovasc Interv. 2020; 95: 675-683
- Comparison of acute kidney injury with radial vs. femoral access for patients undergoing coronary catheterization: an updated meta-analysis of 46,816 patients.Exp Ther Med. 2020; 20: 42
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Publication history
Published online: June 09, 2022
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© 2022 Australian and New Zealand Society of Cardiac and Thoracic Surgeons (ANZSCTS) and the Cardiac Society of Australia and New Zealand (CSANZ). Published by Elsevier B.V. All rights reserved.
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- Predictors of Radial to Femoral Artery Access Crossover During Primary Percutaneous Coronary Intervention for ST-Elevation Myocardial InfarctionHeart, Lung and CirculationVol. 31Issue 7
