A Call to Arms: Radial Artery Access for Percutaneous Coronary Intervention
Authors: Michael P. Savage, David L. Fischman, Nicholas J. Ruggiero
Journal: Annals of Internal Medicine (2015)

Editorials15 December 2015A Call to Arms: Radial Artery Access for Percutaneous Coronary InterventionMichael P. Savage, MD, David L. Fischman, MD, and Nicholas J. Ruggiero, MDMichael P. Savage, MDFrom Thomas Jefferson University, Philadelphia, Pennsylvania.Search for more papers by this author, David L. Fischman, MDFrom Thomas Jefferson University, Philadelphia, Pennsylvania.Search for more papers by this author, and Nicholas J. Ruggiero, MDFrom Thomas Jefferson University, Philadelphia, Pennsylvania.Search for more papers by this authorAuthor, Article, and Disclosure Informationhttps://doi.org/10.7326/M15-2444 Annals Author Insight Video - Michael P. Savage, MD In this video, Michael P. Savage, MD, offers additional insight into his Editorial, "A Call to Arms: Radial Artery Access for Percutaneous Coronary Intervention." SectionsAboutFull TextPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissions ShareFacebookTwitterLinkedInRedditEmail Peripheral vascular access complications persist as risks of cardiac catheterization and percutaneous coronary intervention (PCI). With the increasing popularity of radial artery access, the pendulum of the preferred access site is swinging again—initially from the arm, to the leg, and now back to the arm. The technique of selective coronary angiography introduced by Dr. F. Mason Sones was a pivotal development that ushered in the modern era of coronary revascularization with bypass surgery and coronary angioplasty (1). The Sones technique used the arm for vascular access by surgical cutdown of the brachial artery. Subsequently, percutaneous access was obtained using the ...References1. Ryan TJ. The coronary angiogram and its seminal contributions to cardiovascular medicine over five decades. Circulation. 2002;106:752-6. [PMID: 12163439] CrossrefMedlineGoogle Scholar2. Fischman DL, Leon MB, Baim DS, Schatz RA, Savage MP, Penn I, et al. A randomized comparison of coronary-stent placement and balloon angioplasty in the treatment of coronary artery disease. Stent Restenosis Study Investigators. N Engl J Med. 1994;331:496-501. [PMID: 8041414] CrossrefMedlineGoogle Scholar3. Singh M. Bleeding avoidance strategies during percutaneous coronary interventions. J Am Coll Cardiol. 2015;65:2225-38. [PMID: 25998668] CrossrefMedlineGoogle Scholar4. Kiemeneij F, Laarman GJ. Percutaneous transradial artery approach for coronary stent implantation. Cathet Cardiovasc Diagn. 1993;30:173-8. [PMID: 8221875] CrossrefMedlineGoogle Scholar5. Feldman DN, Swaminathan RV, Kaltenbach LA, Baklanov DV, Kim LK, Wong SC, et al. Adoption of radial access and comparison of outcomes to femoral access in percutaneous coronary intervention: an updated report from the national cardiovascular data registry (2007-2012). Circulation. 2013;127:2295-306. [PMID: 23753843] CrossrefMedlineGoogle Scholar6. Jolly SS, Amlani S, Hamon M, Yusuf S, Mehta SR. Radial versus femoral access for coronary angiography or intervention and the impact on major bleeding and ischemic events: a systematic review and meta-analysis of randomized trials. Am Heart J. 2009;157:132-40. [PMID: 19081409] CrossrefMedlineGoogle Scholar7. Andò G, Capodanno D. Radial versus femoral access in invasively managed patients with acute coronary syndrome. A systematic review and meta-analysis. Ann Intern Med. 2015;163:932-40. doi:10.7326/M15-1277 LinkGoogle Scholar8. Jolly SS, Yusuf S, Cairns J, Niemelä K, Xavier D, Widimsky P, et al; RIVAL trial group. Radial versus femoral access for coronary angiography and intervention in patients with acute coronary syndromes (RIVAL): a randomised, parallel group, multicentre trial. Lancet. 2011;377:1409-20. [PMID: 21470671] CrossrefMedlineGoogle Scholar9. Stone GW, Witzenbichler B, Guagliumi G, Peruga JZ, Brodie BR, Dudek D, et al; HORIZONS-AMI Trial Investigators. Bivalirudin during primary PCI in acute myocardial infarction. N Engl J Med. 2008;358:2218-30. [PMID: 18499566] CrossrefMedlineGoogle Scholar10. Valgimigli M, Gagnor A, Calabró P, Frigoli E, Leonardi S, Zaro T, et al; MATRIX Investigators. Radial versus femoral access in patients with acute coronary syndromes undergoing invasive management: a randomised multicentre trial. Lancet. 2015;385:2465-76. [PMID: 25791214] doi:10.1016/S0140-6736(15)60292-6 CrossrefMedlineGoogle Scholar Author, Article, and Disclosure InformationAffiliations: From Thomas Jefferson University, Philadelphia, Pennsylvania.Disclosures: Authors have disclosed no conflicts of interest. Forms can be viewed at www.acponline.org/authors/icmje/ConflictOfInterestForms.do?msNum=M15-2444.Corresponding Author: Michael P. Savage, MD, Jefferson Angioplasty Center, 111 South 11th Street, Gibbon Building, Suite 6210, Thomas Jefferson University Hospital, Philadelphia, PA 19107; e-mail, Michael.[email protected]edu.Current Author Addresses: Drs. Savage, Fischman, and Ruggiero: Jefferson Angioplasty Center, 111 South 11th Street, Gibbon Building, Suite 6210, Thomas Jefferson University Hospital, Philadelphia, PA 19107.This article was published online first at www.annals.org on 10 November 2015. PreviousarticleNextarticle Advertisement Annals Author Insight Video - Michael P. Savage, MD In this video, Michael P. Savage, MD, offers additional insight into his Editorial, "A Call to Arms: Radial Artery Access for Percutaneous Coronary Intervention." FiguresReferencesRelatedDetails Metrics Cited byBody mass index and all‐cause mortality in patients with percutaneous coronary intervention: A dose–response meta‐analysis of obesity paradoxPercutaneous Coronary Intervention and the Obesity ParadoxBleeding Avoidance Strategies, Performance Measures, and the Emperor’s New Clothes 15 December 2015Volume 163, Issue 12Page: 956-957KeywordsArteriesCatheterizationFemoral arteriesHemorrhageMyocardial infarctionPercutaneous coronary interventionStent implantation ePublished: 10 November 2015 Issue Published: 15 December 2015 Copyright & PermissionsCopyright © 2015 by American College of Physicians. All Rights Reserved.PDF downloadLoading ...