Transradial PCI for Complex PCI: An Overview

Abstract

As outlined in this textbook, radial approach for angiography and coronary intervention is rapidly growing worldwide. This adoption is being driven by improved safety over the traditional femoral approach and by studies demonstrating lower costs and patient preference for radial access. Details of these studies are reviewed elsewhere in this text and strongly support the use of radial approach to achieve the best outcomes, in terms of bleeding or vascular complications, at the lowest cost. An equally important issue is whether radial access can achieve similar efficacy to femoral approach – namely, can complex PCI be performed successfully via radial approach? In order to examine this issue appropriately, it is important to review the existing data comparing radial with femoral approach for procedure success, determine whether ad hoc PCI can be performed after transradial diagnostic angiography, and whether a “radial first” approach can be used for all lesion subset.