The transradial approach to percutaneous coronary intervention: historical perspective, current concepts, and future directions.

Published

Journal Article

Periprocedural bleeding complications after percutaneous coronary intervention (PCI) are associated with increased short- and long-term morbidity and mortality. Although clinical trials have primarily assessed pharmacological strategies for reducing bleeding risk, there is a mounting body of evidence suggesting that adoption of a transradial rather than a transfemoral approach to PCI may permit greater reductions in bleeding risk than have been achieved with pharmacological strategies alone. However, despite a long history of use, a lack of widespread uptake by physicians coupled with the technological limitations of available devices has in the past confined transradial PCI to the status of a niche procedure, and many operators lack experience in this technique. In this review, we examine the history of the transradial approach to PCI and discuss some of the circumstances that have hitherto limited its appeal. We then review the current state of the peer-reviewed literature supporting its use and summarize the unresolved issues affecting broader application of this technique, including lack of operator familiarity and an insufficient evidence base for guiding practice. Finally, we describe potential directions for future investigation in the transradial realm.

Full Text

Duke Authors

Cited Authors

  • Rao, SV; Cohen, MG; Kandzari, DE; Bertrand, OF; Gilchrist, IC

Published Date

  • May 2010

Published In

Volume / Issue

  • 55 / 20

Start / End Page

  • 2187 - 2195

PubMed ID

  • 20466199

Pubmed Central ID

  • 20466199

Electronic International Standard Serial Number (EISSN)

  • 1558-3597

International Standard Serial Number (ISSN)

  • 0735-1097

Digital Object Identifier (DOI)

  • 10.1016/j.jacc.2010.01.039

Language

  • eng