Transradial access is currently the preferred access for diagnostic and therapeutic interventions. However, about 7% of patients experience radial artery occlusion (RAO), which is not expressed by clinical symptoms. However, RAO is a limit for future interventions; it reduces the potential use of that artery as a conduit for aorto-coronary bypass and for the creation...
DISCO RADIAL: Conventional or Distal Transradial Access?
Conventional transradial access (TRA) is already established as the access of choice for percutaneous coronary procedures, regardless of clinical presentation. This choice is based on multiple randomized studies and meta-analyses that have shown reduced bleeding at the puncture site, less vascular complications, and benefits on mortality (mainly in high-risk patients). The practicality of recovery allows...
[APT Medical Sponsored Clinical Case] Bilateral Distal Transradial Access for Chronic Total Occlusion Recanalization and Multivessel Coronary Disease Percutaneous Intervention
Introduction Chronic total occlusion (CTO) represents the most challenging setting for percutaneous coronary intervention (PCI) and multivessel coronary disease (MCD) is often treated in a staggered manner and in a deferred procedure. Although transfemoral is one of the common access site, the transradial access (TRA) has been used with similar procedural success [1]. The distal...
Pending Challenges in Transradial Access
The recent SAFARI-STEMI study compared transradial and femoral access in patients with ST-segment elevation myocardial infarction, and no significant differences were found. These results have a sour taste for those in favor of transradial access, as they are convinced of its benefits and unwilling to go back to previous practices. This bitter taste is based...
Less Bivalirudin and Minimal Use of Ultrasound for Puncture Is the Worldwide Trend in Transradial Access
A worldwide survey shows there is much room for improvement as regards transradial access procedures, particularly for the prevention of radial artery occlusion post-procedure. While in many places this has been a standard technique for some time now, other places are yet to evolve, and that is the result of this survey. In the past...
ESC 2018 | MATRIX: 1-Year Superiority of Transradial Access
Transradial access should be the access of choice in patients with acute coronary syndrome, while bivalirudin has not shown any benefit for this population. The long-term follow-up from the MATRIX (Minimizing Adverse Hemorrhagic Events by Transradial Access Site and Systemic Implementation of Angiox) trial confirms the results at 30 days: transradial access is here to stay...
Important Study Suggests that Rotational Atherectomy Is Feasible with Transradial Access
Rotational atherectomy is a very important tool in the treatment of heavily calcified and non-dilatable lesions. Historically, transfemoral access has been the gold standard due to a perceived need for large-bore guidewire catheters in order to use spheroids for proper debulking. Nowadays, rotational atherectomy has evolved towards a technique that aims to modify plaque for...
Transradial Access and Early Discharge in Percutaneous Interventions
Transradial Access and Early Discharge in Percutaneous Interventions. Presenters: Dr. Jorge Mayol, Uruguay. Dr. Anibal Damonte, Argentina. This video, sponsored and funded by Medtronic, was filmed during SOLACI-CACI 2017 Congress, at Hilton Buenos Aires Hotel (in Argentina). Do you want to take a look at all other SOLACI-CACI 2017 Congress Medtronic cases? Watch them We are interested in your...
Transradial access shows no benefit of bivalirudin
The aim of this study was to compare bivalirudin against heparin in patients with ST elevation acute myocardial infarction undergoing transradial primary PCI. Both bivalirudin and the transradial access are strategies aimed at reducing bleeding complications in patients undergoing acute MI. However, the benefit of their combined use is not year clear. Even though...
Right vs. Left Transradial Access for Coronary Procedures
Courtesy of Dr. Guillermo Migliaro. Coronary angiography and angioplasty via transradial approach are associated with a significant reduction in access site complications, compared with transfemoral and transbrachial access. Moreover, a significant reduction in mortality has been reported for procedures performed via transradial approach vs. transfemoral approach in primary angioplasty. There is a limited number...