Related Experiment Video
Updated: Mar 21, 2026

Upper-extremity Approach for Secondary Access in Transfemoral Transcatheter Aortic Valve Implantation
Published on: August 8, 2025
Compared to femoral venous access, upper extremity right heart catheterization reduces time to ambulation: A single
Bernadette Speiser1, Katrina Pearson1, Hui Xie2
1Department of Veterans Affairs, Jesse Brown VA Medical Center, Chicago, Illinois.
Objectives:
To determine ambulation times after right heart catheterization (RHC) via upper extremity access compared to femoral venous access.
Background:
Transradial coronary angiography has been associated with shorter times to ambulation. We hypothesized that RHC from the upper extremity would be similarly associated with shorter ambulation times when compared to traditional femoral access.
Methods:
We performed a single-center retrospective analysis of 379 consecutive patients who underwent a variety of diagnostic and interventional left- and right-heart procedures through upper extremity and femoral access sites.
Results:
The time to ambulation for RHC through the arm veins versus the femoral vein was lower (42.6 min ± 14.2 vs. 175.0 min ± 65.0, P < 0.001). Fluoroscopy times (8.5 min ± 6.8 vs. 12.8 min ± 8.4, P < 0.001) and radiation doses (64.1 Gy cm-2 ± 60.0 vs. 108.5 Gy cm-2 ± 71.6, P < 0.001) were reduced in the radial compared to femoral group, respectively. In multivariate analyses, upper arm access (P < 0.0001), lower heparin dose (P = 0.032), inpatient status (P = 0.01), and concurrent PCI (P = 0.03) were associated with shorter times to ambulation.
Conclusions:
Right heart catheterization from the upper extremity is strongly associated with shorter times to ambulation. © 2016 Wiley Periodicals, Inc.
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