Radial access for percutaneous coronary intervention (PCI) accounts for one out of six PCI procedures, and is associated with lower vascular and bleeding complication rates when compared to femoral access, according to a study published June 11 in Circulation.

Additional Resources CathPCI Registry® ACCF/AHA/SCAI 2011 Guideline for PCI

The study was a retrospective cohort study and looked at five years of data from 2,820,874 procedures in the CathPCI Registry®. Results showed that radial access accounted for 6.3 percent of the procedures from 2007 to 2012, and after multivariable adjustment, radial PCI was associated with lower risk of bleeding (adjusted odds ratio, 0.51; 95 percent confidence interval, 0.49–0.54) and lower risk of vascular complications (adjusted odds ratio, 0.39; 95 percent confidence interval, 0.31–0.50) in comparison with transfemoral PCI. Further, "the reduction in bleeding and vascular complications was consistent across important subgroups of age, sex, and clinical presentation."

The authors note that since early reports, "there has been a 13-fold increase over a period of six years in the use of [radial] PCI." They add that "these findings indicate similar efficacy and improved safety of [radial] PCI in comparison with [femoral] PCI." However, there is geographic variation in its adoption, and underused in patients at high risk for bleeding.

Moving forward, "wider adoption of [radial] PCI in interventional practice, particularly in higher-risk patients, presents an opportunity to potentially improve overall PCI safety," the authors add.

Clinical Topics: Invasive Cardiovascular Angiography and Intervention

Keywords: Odds Ratio, Registries, Confidence Intervals, Hemorrhage, Percutaneous Coronary Intervention

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