Rao Sunil V. Transradial Angiography and Intervention

Elsevier, 2015. — 109 p. — (Interventional Cardiology Clinics. Volume 4, Number 2). - ISBN13: 978-0-323-35977-1Bleeding is the most common complication of percutaneous coronary intervention (PCI), occurring in up to 10% of patients. A substantial proportion of bleeding is related to the vascular access site, and studies indicate that such complications are associated with increased morbidity, mortality, and costs. These complications are also largely preventable. The most effective strategy to reduce bleeding risk from PCI is to use the radial artery instead of the femoral artery. Transradial PCI is being increasingly adopted, but there is substantial international variation in its use. In
particular, certain countries, such as the United States, lag behind other countries, such as India and Japan. This may be due to the lack of concise
information on best practices and techniques. There also has been a significant increase in the number of publications on the radial approach
examining high-risk subsets and clinical and nonclinical outcomes. Observational and randomized studies have shown that radial access reduces
mortality in patients with ST-segment elevation myocardial infarction (STEMI) and reduces hospital length of stay and costs compared with traditional femoral access.
This issue of Interventional Cardiology Clinics provides an in-depth examination of relevant transradial topics written by international experts for the
practicing interventional cardiologist. The issue includes such topics as radial arterial access, hemostasis and radial artery occlusion; traversing the arm and chest vasculature; and diagnostic and guide catheter selection. Also found in the issue are advanced topics such as sheathless techniques,
transradial primary PCI for STEMI, use of radial access for peripheral arterial procedures, and recognition and management of complications. In
addition, topics such as the radial learning curve and the interaction between access site and antithrombotic therapy are also explored.
Importantly, each article focuses on practical information that is readily translatable to clinical practice. Taken together, this compendium represents the best contemporary information on radial access, which will contribute to improving the care of patients undergoing PCI.