Original title: Comparison of bivalirudin and radial access across a spectrum of preprocedural risk of bleeding in percutaneous coronary intervention: Analysis from the National Cardiovascular Data Registry. Reference: Baklanov DV et al. Circ Cardiovasc Interv. 2013, article in press. Bleeding complications are clearly associated to mortality increase and two of the current best strategies to reduce bleeding are...
Courtesy of Dr. Carlos Fava. One of the major challenges we interventional cardiologists still face is access management. Reduced device diameter and improved transcatheter closure, together with increased operator experience, have significantly reduced vascular complications. However, we shouldn’t lose sight of the secondary access, usually transfemoral, generally used in case of primary access site related...
Original Title: Radial versus femoral access in patients with acute coronary syndromes with or without ST-segment elevation. Presenter: Bernardo Cortese. The MATRIX study showed that the transradial access is associated with a reduction of combined events, death, infarction, stroke and bleeding, compared to femoral access, in ACS patients. The goal of this sub-analyzis was...
Original Title: The Benefits Conferred by Radial Access for Cardiac Catheterization Are Offset by a Paradoxical Increase in the Rate of Vascular Access Site Complications with Femoral Access: The Campeau Radial Paradox. Reference: Lorenzo Azzalini et al. J Am Coll Cardiol Intv. 2015, ONLINE FIRST. The aim of this study was to assess whether the benefit of the radial access...
Currently, transfemoral access (TFA) is used in large-caliber procedures and when transradial access fails. The introduction of ultrasound (US) to guide access has emerged as a technique that allows for precise channeling, avoiding accesses above or below the inguinal ligament. However, evidence regarding the use of this tool has shown diverse results. Two surveys conducted...
The first experiences with distal radial access (DRA) have revealed significant benefits compared against the transradial approach (TRA), showing reduced bleeding events and better puncture site occlusion rate. Even the spectrum of diseases treated with DRA has grown, and now includes chronic total occlusion (CTO) though 7Fr inductors, such as Terumo’s Glidesheath Slender. The aim...
Currently, transfemoral access (TFA) is used in large-caliber procedures and when transradial access is not successful. The use of ultrasound (US) to guide access has emerged as a technique that allows for precise cannulation, avoiding accesses above and below the inguinal ligament. However, evidence regarding the effectiveness of this tool has shown variable results. Two...
In 1992, Kiemeneij performed the first transradial coronary procedure, following Campeau’s description of that access in 1989. It’s been 30 years since that milestone in interventional cardiology. Over time, the number of procedures conducted with this approach has increased exponentially, and it is the main approach in most centers in different clinical scenarios. Historically, the...
Angioplasty by transradial access was discussed during a session on Day 2. We were pleased to participate in a conference by Dr. Shigeru Saito on distal radial access. Currently, complications associated with transfemoral access are well-established, so transradial access is suggested as the initial strategy in several guidelines of various associations. However, Dr. Saito shared...
The benefit of the transradial approach in percutaneous interventions is well known. Its main limitation is radial artery occlusion (RAO) which would compromise the artery for future use in percutaneous procedures. Even though it is clinically silent, reported cases might reach 33%. More recently, the distal radial access (DRA) has surged as an alternative to...