Transradial Approach in Primary Percutaneous Coronary Intervention: Lessons from a High-volume Centre

Area of Science:

• Cardiology
• Interventional Cardiology
• Vascular Access

Background:

• The transradial approach (TRA) is recommended for percutaneous coronary intervention (PCI) in acute coronary syndrome (ACS) by European guidelines.
• TRA offers reduced bleeding complications and mortality, alongside enhanced patient convenience through early mobilization.
• TRA facilitates early invasive therapy for ST-elevation myocardial infarction (STEMI) and non-ST-elevation myocardial infarction (NSTEMI).

Purpose of the Study:

• To evaluate the effectiveness and outcomes of the transradial approach (TRA) compared to the transfemoral approach (TFA) in percutaneous coronary intervention (PCI).
• To assess the procedural success and clinical results of TRA in high-volume experienced operators.
• To address the challenges and learning curve associated with TRA adoption.

Main Methods:

• Review of existing evidence and guidelines supporting the transradial approach (TRA).
• Comparison of procedural outcomes and clinical results between TRA and transfemoral approach (TFA).
• Analysis of factors influencing TRA adoption, including operator experience and center volume.

Main Results:

• TRA is associated with significant reductions in bleeding and mortality compared to TFA.
• Experienced, high-volume operators achieve procedural outcomes with TRA comparable to TFA.
• Despite technical challenges and a learning curve, TRA demonstrates favorable clinical results, including in primary PCI.

Conclusions:

• The transradial approach (TRA) is a safe and effective method for percutaneous coronary intervention (PCI), recommended by guidelines.
• TRA offers significant patient benefits, including reduced complications and improved early mobilization.
• High-volume, experienced operators can successfully implement TRA, achieving outcomes on par with the transfemoral approach (TFA).