To describe Transradial vascular access highlighting anatomical and technical aspects, the procedural planning, the radioprotection, the indications and contraindications and the anaesthetic protocol;
To illustrate the step-by-step procedure with special focus on tips-&-tricks and learning curve.
Since transradial artery access has gained great popularity among cardiologists for percutaneous coronary angiography and intervention, many interventional radiologists look at this vascular access route with renewed interest. It has many potential advantages (in the case of obese patient or patients with coagulopathies) and could be considered as a safe and effective alternative to standard Transfemoral access.
The transradial approach (TRA) has gained significant interest, and a growing body of evidence from the coronary literature has demonstrated this method to be safer than the transfemoral...
Findings and procedure details
The knowledge of the arterial anatomy of the district is essential to choose the right point of puncture.
The radial artery is one of two continuations of the brachial artery, the other being the ulnar artery. It supplies the anterior compartment of the forearm. The radial and ulnar arteries originate as a bifurcation of the axillary artery in the cubital fossa and serve as the major perforators to the forearm. Following its bifurcation, the radial artery runs along the lateral aspect of the...
Transradial access is associated with a lower rate of access-site complication and may be preferable in some patients. A modern IR should be able to perform it when possible. The essential information here reported may help residents to start their training into “transradial world”.
Personal information and conflict of interest
D. G. Castiglione; Palermo/IT - nothing to disclose A. Basile; Catania/IT - nothing to disclose T. V. Bartolotta; Cefalù/IT - nothing to disclose A. G. Musumeci; Catania/IT - nothing to disclose O. G. Grassi; Catania/IT - nothing to disclose D. Falsaperla; Catania/IT - nothing to disclose A. G. Torcitto; Catania/IT - nothing to disclose
-Agostoni P, Biondi-Zoccai GG, de Benedictis ML, et al. Radial versus femoral approach for percutaneous coronary diagnostic and interventional procedures; Systematic overview and meta-analysis of randomized trials. J Am Coll Cardiol. 2004;44:349–356
-Cox N, Resnic FS, Popma JJ, Simon DI, Eisenhauer AC, Rogers C. Comparison of the risk of vascular complications associated with femoral and radial access coronary catheterization procedures in obese versus nonobese patients. Am J Cardiol. 2004;94:1174–1177.
-Jolly SS, Yusuf S, Cairns J, et al. Radial versus femoral access for coronary angiography and...