Radial and Left Radial Articles for StandTall

Most up to date Guidelines: Radial recommended

Recommend Radial artery first with AHA, not with SCAI.

  • They now recommend radial access first, level one evidence and now up to date with European consensus. This will have large impact on rapidity of conversion to radial access.

Mason PJ, Shah B and Gilchrist IC et al. An Update on Radial Artery Access and Best Practices for Transradial Coronary Angiography and Intervention in Acute Coronary Syndrome. A Scientific Statement from the American Heart Association. Circ Cardiovasc Interv. 2018;11: e000035. DOI: 10.1161/HCV.0000000000000035.
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Most Up-to-date Guidelines: Radial Recommended

  • Recommends Radial access but does not make it level one evidence. (2) Supports similar left radial recommendations as AHA.

Rao S, Tremmel JA and Pancholy S et al. Best Practices for Transradial Angiography and Intervention: A Consensus Statement from the Society for Cardiovascular Angiography and Intervention’s Transradial Working Group. Catheterization and Cardiovascular Interventions 83:228–236 (2014).
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Cost advantages with Radial Access

  • $1000 savings on average using Radial access versus femoral access.
  • Less staff time radial vs. femoral.
  • 3-times higher likelihood of same day discharge radial vs. femoral

Amin A and Marso S et al. Costs Associated with Access Site and Same-Day Discharge Among Medicare Beneficiaries Undergoing Percutaneous Coronary Intervention: An Evaluation of the Current Percutaneous Coronary Intervention Care Pathways in the United States. JACC: CARDIOVASCULAR INTERVENTIONS 10, N O. 4, FEBRUARY 27, 2017:342 – 5.
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Advantages of Left Radial

  • Summary of Left radial advantages. Left Radial recommended as primary access consideration in:
    (i) elderly, (>75 years),
    (ii) short (less than 5 foot 6 inches)
    (iii) Prior CABG, LIMA
    (iv) Chronic HTN
    (v) Early bail out.

Lardizabel J and Cohen M. Radial Artery Access. Safe and effective methods for patient assessment and procedural setup from the left or right radial approach. Cardiac Intervention Today, May June 2012.
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