PCI with radial access site is associated with lower rates of in-hospital mortality, major access site bleeding and other major vascular complications vs. femoral access site and has increased in use in the U.S. over the past decade, overtaking femoral access site, according to an article published July 4 in the European Heart Journal.

Reza Fazel, MD, FACC, et al., used data from the ACC's CathPCI Registry, to analyze 6,658,479 PCI procedures from Jan. 1, 2013, to June 30, 2022, and 2,420,805 PCIs met the criteria to be included in the safety analysis. They explored temporal trends in the use of radial access for PCI and compared outcomes of procedures using radial vs. femoral access.

Results showed that about 40% of PCI procedures were performed via radial access. This rate increased from 20% in 2013 to 58% in 2022. While this trend was observed regardless of geographic region or patient presentation, the largest increase in use of radial access site was seen among STEMI patients.

The authors also found that radial access site was associated with a decreased risk for in-hospital mortality (absolute risk difference [ARD] –0.15%), major access site bleeding (ARD –0.64%) and other major vascular complications (ARD –0.21%), when compared to femoral access site. However, patients undergoing PCI via radial access were more likely to suffer ischemic stroke (ARD 0.05%).

"These results demonstrate a transformation in the manner in which PCI is performed in the US over the past decade and confirm that the benefits of radial access site for PCI that were observed in randomized clinical trials have translated to clinical improvements in outcomes in contemporary, real-world practice," state the authors.