Revascularization Guidelines Series-Vascular Access: Finally Radial Access is Class IA!

Video Transcription

Video Summary

In this video, Sunil Rao discusses the implementation of transradial access in the US and its impact on reducing bleeding risk and mortality in patients undergoing percutaneous coronary intervention (PCI). He highlights that bleeding complications are common and associated with increased morbidity and mortality. Randomized trials have shown that radial access reduces bleeding across the spectrum of ischemic heart disease and also reduces mortality in high-risk patients, particularly those with ST-segment elevation myocardial infarction (STEMI). Rao presents data indicating that radial access has been increasingly adopted in the US, with 63% of diagnostic caths and 54% of PCIs being performed via radial access. Pooled analyses from multiple studies demonstrate that radial access reduces major bleeding by 47% compared to femoral access and also reduces mortality. Consequently, Rao concludes that radial access meets the criteria for a class 1, level of evidence A recommendation in the ACC AHA Sky revascularization guidelines for patients with both stable ischemic heart disease and ACS undergoing PCI.

Asset Subtitle

Sunil V. Rao, MD, FSCAI

Keywords

transradial access

bleeding risk

mortality

percutaneous coronary intervention

PCI