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Radial Artery Access for Acute Coronary Syndromes: a Review of Current Evidence

  • Management of Acute Coronary Syndromes (H Jneid, Section Editor)
  • Published:
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Abstract

Purpose of Review

To review the evidence supporting the use of transradial access (TRA) for percutaneous coronary intervention (PCI) in acute coronary syndromes (ACS).

Recent Findings

There have been five major randomized controlled trials (RCTs) and two recent meta-analyses comparing outcomes of TRA and femoral access (FA) in ACS. Additional studies have explored the impact of TRA on STEMI door-to-balloon (D2B) times, TRA in high-risk ACS patients, the potential conflict between TRA and coronary artery bypass graft (CABG) surgery employing the radial artery, and distal radial artery (DRA) access.

Summary

TRA is associated with a reduction in net adverse clinical events, major bleeding, acute renal injury, and access site complications compared to FA in ACS patients undergoing PCI. TRA is not associated with significant delays in STEMI D2B times that impact patient outcomes. Further studies are needed to evaluate the role of TRA in high-risk ACS patients, the interplay between TRA and radial artery CABG, and use of DRA in ACS.

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References

Papers of particular interest, published recently, have been highlighted as: • Of importance •• Of major importance

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Authors and Affiliations

  1. Rocky Mountain VA Medical Center, 1700 N Wheeling St, Aurora, CO, 80045, USA

    Christopher Kovach & Stephen Waldo

  2. University of Colorado Anschutz Medical Campus, Aurora, CO, USA

    Christopher Kovach & Stephen Waldo

  3. VA North Texas Healthcare System, Dallas, TX, USA

    Subhash Banerjee

  4. University of Texas Southwestern Medical Center, Dallas, TX, USA

    Subhash Banerjee

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Dr. Kovach has nothing to disclose. Dr. Banerjee reports personal fees from Medtronic, Cordis, and KANEKA; and grants from Boston Scientific Corp. and Chiesi, during the conduct of the study. Dr. Waldo has received unrelated investigator-initiated research support from Abiomed, Cardiovascular Systems Incorporated, Janssen Pharmaceuticals, National Institutes of Health, and VA Health Services Research and Development. The views expressed in this article are those of the authors and do not necessarily reflect the position or policy of the Department of Veterans Affairs or the United States Government.

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Kovach, C., Banerjee, S. & Waldo, S. Radial Artery Access for Acute Coronary Syndromes: a Review of Current Evidence. Curr Cardiol Rep 24, 383–392 (2022). https://doi.org/10.1007/s11886-022-01656-x

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