Journal
JOURNAL OF THE AMERICAN COLLEGE OF CARDIOLOGY
Volume 55, Issue 20, Pages 2187-2195Publisher
ELSEVIER SCIENCE INC
DOI: 10.1016/j.jacc.2010.01.039
Keywords
acute coronary syndromes; percutaneous coronary intervention; review; transradial
Categories
Funding
- Terumo Medical
- Portola Pharmaceuticals
- Momenta Pharmaceuticals
- Cordis Corporation
- Medtronic
- Abbott Vascular
- Cordis
- GE Healthcare
- AstraZeneca
- Eisi Medical Research
- Hoffman-LaRoche
- Boston Scientific
- Angel Medical
- Bristol- Myers Squibb
- Osiris Therapeutics Inc
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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. (J Am Coll Cardiol 2010;55:2187-95) (C) 2010 by the American College of Cardiology Foundation
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