Radial Artery Access Lowers Angiography and PCI Complications

Marco Valgimigli, MD, PhD Erasmus MC, Thoraxcenter, Rotterdam  The NetherlandMedicalResearch.com Interview with:
Marco Valgimigli, MD, PhD
Erasmus MC, Thoraxcenter,
Rotterdam  The Netherlands

MedicalResearch: What is the background for this study? What are the main findings?

Dr. Valgimigli: Interventional cardiologists can choose between two entry sites in order to perform a diagnostic coronary angiography and or a percutaneous coronary intervention, namely an artery which is in the groin called femoral artery or an artery which is located in the wrist which is called radial artery. The latter is more superficial and has small calibre as compared to the former. Femoral artery is the entry site which is most frequently used in the world especially in US where the use of radial artery is relatively limited.

Our study randomly allocated 8,404 patients to undergo diagnostic coronary angiography and PCI, if clinically indicated, either vie the femoral or the radial artery.

The main results of our study are that radial access reduced the composite of net adverse clinical events driven by a reduction of mortality and of major bleeding, including transfusions and need for surgical repair or the entry site.

MedicalResearch: What should clinicians and patients take away from your report?

Dr. Valgimigli: The entry site which needs to be preferred is today the radial artery. Femoral artery, as entry site, given the entity and magnitude of the benefit observed in our study, should be considered as bailout option meaning that it should be accessed only of radial intervention is not possible or feasible.

MedicalResearch: What recommendations do you have for future research as a result of this study?

Dr. Valgimigli:  After MATRIX, given the sound mortality benefit observed here, it will be difficult to envision other randomised studies comparing these two entry sites. Radial is superior and it may not be ethical anymore to keep exposing patients to transferral intervention. I think next steps will be how to optimise the procedure performed via trans-radial intervention, including how to minimise the risks of occlusion of the artery after the procedure.

Citation:

Radial versus femoral access in patients with acute coronary syndromes undergoing invasive management: randomised multicentre trial

The Lancet Published Online: 16 March 2015
DOI: http://dx.doi.org/10.1016/S0140-6736(15)60292-6
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MedicalResearch.com Interview with: Marco Valgimigli, MD, PhD (2015). Radial Artery Access Lowers Angiography and PCI Complications 

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