[Transradial access for percutaneous coronary and non-coronary interventions]

The transfemoral access is still the most widely used approach for percutaneous coronary and non-coronary interventions. However, the transradial access has been increasingly used, mostly because it is associated with less hemorrhagic complications. The present review is aimed at evaluating the use of the transradial access for percutaneous vascular interventions. In many institutions, the radial artery is already the preferred vascular access for coronary procedures for routine coronary angiography but also for complex interventions such as primary angioplasty and angioplasty for stenosis at coronary bifurcations or coronary bypass grafts, or for treating chronic coronary occlusions. The radial artery can be used also as a vascular access for percutaneous peripheral interventions. Supra-aortic vessels (carotid, subclavian and vertebral arteries) can be treated via the radial route when obstructions of the femoro-iliac tract preclude groin access or also to circumvent anatomic variations such as bovine aortic arch. For renal artery angioplasty, the transradial access can be considered ideal for anatomic reasons, at least for those operators who use this access routinely for coronary interventions. At present, the transradial access can also be used, although in specific cases, to treat stenosis of the lower limb arteries in above the knee segments.