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Radial approach in percutaneous coronary interventions: current status in Brazil
Pedro Beraldo de Andrade1, Marden André Tebet, Mônoca Vieira Athanazio de Andrade
1Santa Casa de Marília, SP, Brazil. pedroberaldo@gmail.com
Background:
Although the radial approach offers an unquestionable result in terms of reduction of vascular complications and occurrence of severe bleeding in comparison to the femoral approach, so far it has only been used in few centers which elected it as the preferential access.
Objective:
To evaluate the current status of percutaneous coronary interventions in Brazil, as regards the use of the radial approach.
Methods:
Analysis of data spontaneously recorded in Central Nacional de Intervenções Cardiovasculares - CENIC (National Center for Cardiovascular Interventions) from 2005 to 2008, in a total of 83,376 procedures.
Results:
The radial approach was used in 12.6% of the procedures performed, and the femoral approach, in 84.3%. The remaining 3.1% corresponded to brachial artery dissection or puncture. With a success rate of 97.5%, the choice of the radial approach was associated with a significant reduction of vascular complications in comparison to the femoral approach (2.5% versus 3.6 %, p < 0.0001).
Conclusion:
The radial approach remains uncommonly used in Brazil, and this is possibly explained by the lack of training programs, uncertainties regarding the learning curve, and the lack of large-scale studies corroborating the benefits demonstrated to date.
Related Concept Videos
Assessment of radial pulse
The radial pulse, located at the wrist, is often the preferred site for assessing peripheral pulse because of its accessibility and dependability. The process of determining the radial pulse involves several steps:
Assessment of apical radial pulse
The A-R pulse assessment involves simultaneous evaluation of the apical and radial pulses. When the apical and radial pulse rates vary, this assessment helps identify a pulse deficit.
Pre-Procedural Preparation
Peripheral Artery Disease III: Interprofessional Care
Cardiac Catheterization II: Right Heart Catheterization
Cardiac Catheterization III: Left Heart Catheterization
