Radial Access Approach to Peripheral Vascular Interventions: A Scientific Statement From the American Heart Association

被引:0
作者
Kovacic, Jason C. [1 ,2 ]
Skelding, Kimberly A. [3 ]
Arya, Shipra [4 ]
Ballard-Hernandez, Jennifer [5 ]
Goyal, Mayank [7 ]
Ijioma, Nkechinyere N. [8 ]
Kicielinski, Kimberly [9 ]
Takahashi, Edwin A. [10 ]
Ujueta, Francisco [11 ]
Dangas, George [6 ]
Council Clinical Cardiology
Council Cardiovasc Stroke Nursing
Council Peripheral Vasc Dis
Council Cardiovasc Radiology Intervention
机构
[1] Icahn Sch Med Mt Sinai, New York, NY 10029 USA
[2] Victor Chang Cardiac Res Inst, Darlinghurst, NSW, Australia
[3] Confluence Hlth, Wenatchee, WA USA
[4] Stanford Univ, Sch Med, Stanford, CA USA
[5] Long Beach VA, Long Beach, CA USA
[6] Icahn Sch Med Mt Sinai, Cardiovasc Inst, New York, NY USA
[7] Foothills Med Ctr, Calgary, AB, Canada
[8] Ohio State Univ, Davis Heart & Lung Res Inst, Columbus, OH USA
[9] Med Univ South Carolina, Charleston, SC USA
[10] Mayo Clin, Rochester, MN USA
[11] Brigham & Womens Hosp, Boston, MA USA
关键词
AHA Scientific Statements; angioplasty; endovascular procedures; peripheral arterial disease; radial artery; CORONARY-ANGIOGRAPHY; TRANSRADIAL APPROACH; TRANSFEMORAL ACCESS; ARTERIAL-DISEASE; JOINT COMMITTEE; METAANALYSIS; THROMBECTOMY; FEASIBILITY; GUIDELINE; OUTCOMES;
D O I
10.1161/HCV.0000000000000094
中图分类号
R5 [内科学];
学科分类号
1002 ; 100201 ;
摘要
Transradial arterial access has transformed the field of coronary interventions, where it has several advantages over femoral access, such as reduced bleeding and access site complications, improved patient comfort, shorter time to ambulation after the procedure, reduced length of hospital stay, and potentially reduced mortality rates. Because of these benefits, as well as the concurrent expanding indications for various endovascular therapies, there is growing interest in adopting radial access for peripheral vascular interventions. However, radial access can present challenges, and specialized equipment for peripheral interventions through this route are under development. Nevertheless, a growing number of studies, largely comprising single-center and registry data, have broadly suggested that transradial arterial access is likely to be safe and associated with reduced bleeding and local access site complications for most peripheral interventions compared with transfemoral access. Large, prospective randomized trials are lacking, and the question of any effect on mortality rates has not been addressed. Whereas the field of transradial arterial access for peripheral vascular interventions is in development, it is clear that this approach, at least with available equipment, will not be suitable for all patients, and careful case selection is paramount. Furthermore, the remaining knowledge gaps must be addressed, and robust outcome data obtained, to allow full understanding of the factors that determine optimal patient, lesion, and equipment selection. Nevertheless, the use of transradial arterial access for peripheral vascular interventions holds great promise, particularly if the necessary technologic advances are rapid and favorable clinical trial data continue to emerge.
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页数:11
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