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Updated: Apr 4, 2026
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Published on: March 30, 2019
Percutaneous brachial artery access for coronary artery procedures: Feasible and safe in the current era
Yasir Parviz1, Rebecca Rowe2, Sethumadhavan Vijayan3
1Department of Cardiology, Northern General Hospital, Sheffield, UK.
Insights
Percutaneous trans-brachial access for coronary interventions is feasible and safe, even when radial or femoral routes fail. This approach offers a high success rate with a low complication rate in select patient groups.
Area of Science:
- Cardiology
- Interventional Cardiology
- Vascular Access
Background:
- Radial artery access is the primary method for percutaneous coronary intervention.
- Femoral access serves as a backup, while brachial access is rarely used due to complication concerns.
Purpose of the Study:
- To evaluate the safety and feasibility of percutaneous trans-brachial access.
- To assess outcomes when radial and femoral access are not possible.
Main Methods:
- Retrospective analysis of 117 patients undergoing coronary intervention via brachial route.
- Data collected from a UK tertiary cardiology center (2005-2014).
- Primary endpoints: procedural success and vascular complications.
Main Results:
- Successful procedures in 96% of cases (112/117).
- 11% (13/117) experienced post-procedural complications, with 1.7% (2/117) being serious.
- No procedure-related deaths occurred.
Conclusions:
- Percutaneous trans-brachial arterial access is a viable option.
- It demonstrates high success rates and acceptable complication profiles.
- This technique is suitable for patients with failed radial or femoral access attempts.
Background:
Percutaneous vascular access for coronary intervention is currently achieved predominately via the radial route, the femoral route acting as a backup. Percutaneous trans-brachial access is no longer commonly used due to concerns about vascular complications. This study aimed to investigate the safety and feasibility of percutaneous brachial access when femoral and radial access was not possible.
Methods:
This is a retrospective data analysis of patients who attended a single tertiary cardiology centre in the UK between 2005 and 2014 and had a coronary intervention (coronary angiogram or PCI) via the brachial route. The primary endpoints were procedural success and the occurrence of vascular complications.
Results:
During the study period 26602 patients had a procedure (15655 underwent PCI and 10947 diagnostic angiography). Of these, 117 (0.44% of total) had their procedure performed via the brachial route. The procedure was successful in 96% (112/117) of cases. 13 (11%) patients experienced post procedural complications, of which 2 (1.7%) were serious. There were no deaths.
Conclusion:
Percutaneous trans-brachial arterial access is feasible with a high success rate and without evidence of high complication rate in a rare group of patients in whom femoral or sometimes radial attempts have failed.
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01:28Cardiac Catheterization I: Pre-Procedure Overview
01:24Cardiac Catheterization III: Left Heart Catheterization
01:10Pre-Procedural Guidelines for Assessing Blood Pressure