Top Things to Know: Radial Access Approach to Peripheral Vascular Interventions
Published: December 04, 2024
Prepared by Anne Leonard MPH, RN – National Senior Director AHA Science and Medicine
- Transfemoral arterial access (TFA) has long been the gold standard for arterial interventions, which offers several advantages. However, there are disadvantages, with the main one being vascular complications.
- Trans-radial arterial (TRA) access has transformed the field of coronary interventions as well as peripheral interventions.
- There is a growing body of literature showing the efficacy of endovascular therapies across a spectrum of conditions that were thought to be unsuitable for peripheral vascular intervention (PVI).
- TRA has emerged as a transformative approach for endovascular interventions and indications for endovascular treatment of various visceral, peripheral, and other arterial and nonarterial conditions are increasing.
- This statement describes the indications and lesion types in which using TRA rather than TFA might be the preferred method of access.
- TRA is superior to TFA in certain high-risk groups including women and the elderly. Other pluses to TRA over TFA are quicker ambulation post procedure and it enables early discharge to home post procedure.
- Procedural technical considerations related to TRA for PVIs are outlined in this statement.
- Specific areas addressed in this statement where the TRA approach is employed for the most common PVIs includes neurovascular, renal, mesenteric, uterine, and other interventions in the abdomen or pelvis, iliofemoral, femoropopliteal, inferopopliteal procedures.
- This statement is relevant to vascular interventional proceduralists, surgeons and allied health professionals who work in catheterization laboratories or in interventional suites.
- There is rapidly expanding use of TRA for PVIs what mirrors the same evolution of TRA that occurred in the coronary field in the early 2000’s. This statement discusses the pros and the cons of the use of TRA in PVIs and offers suggestions and considerations to clinicians for its use.
Citation
Kovacic JC, Skelding KA, Arya S, Ballard-Hernandez J, Goyal M, Ijioma NN, Kicielinski K, Takahashi EA, Ujueta F, Dangas G; on behalf of the American Heart Association Cardiovascular Interventions Science Committee of the Council on Clinical Cardiology; Council on Cardiovascular and Stroke Nursing; Council on Peripheral Vascular Disease; and Council on Cardiovascular Radiology and Intervention. Radial access approach to peripheral vascular interventions: a scientific statement from the American Heart Association. Circ Cardiovasc Interv. Published online December 4, 2024. doi: 10.1161/HCV.0000000000000094