Examining the Appropriateness of Radial or Femoral Access

Evidence From the RIVAL Trial and Clinical Practice

Sarah Hale; Tift Mann

Disclosures

Interv Cardiol. 2012;4(6):675-687. 

In This Article

Abstract and Introduction

Abstract

Multiple studies over the past 20 years have shown that transradial access for percutaneous coronary interventional procedures may have a distinct advantage over the transfemoral approach, in that access-site bleeding complications are virtually eliminated. Although there have been significant advances in antithrombotic therapy and interventional techniques, bleeding complications remain a significant source of morbidity and mortality in these patients. Furthermore, the results of the recent RIVAL trial have created further controversy regarding access site efficacy. The purpose of the present paper is to evaluate the role of transradial access in contemporary practice.

Introduction

Currently more than 4 million percutaneous coronary interventions (PCIs) are performed each year in the world [Boston Scientific, Pers. Comm.]. Multiple studies over the past 20 years have shown that transradial access for PCI may have a distinct advantage over the transfemoral approach, in that access-site bleeding complications are virtually eliminated. As a result, transradial access has been accepted worldwide as a preferred strategy for PCI. Although there have been significant advances in antithrombotic therapy and interventional technique, bleeding complications remain a significant source of morbidity and mortality in patients undergoing PCI from femoral access. The purpose of the present paper is to review the evolution of contemporary femoral PCI techniques, and evaluate the role of transradial access in improving results.

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