What’s New in Transradial Access

Abstract

Transradial access (TRA) is a key strategy to avoid bleeding during percutaneous coronary intervention (PCI) and coronary angiography, as it reduces the risk of bleeding associated with transfemoral access (TFA). The distal radial artery (dRA) is located at the anatomical snuffbox, or radial fossa, which is a triangular depression on the lateral aspect of the dorsum of the hand. Distal transradial access (dTRA) at the anatomical snuffbox has recently gained interest as a non-femoral alternative access route for vascular procedures. Opportunities and challenges in the TRA/dTRA space include adoption of different and more complex procedures, technical innovation in access and haemostasis, and financial savings for institutions and healthcare systems. Historically, the adoption of TRA has been concentrated among interventional cardiologists, with much less adoption in the interventional radiology, vascular surgery, and neurointerventional radiology communities. This article highlights key aspects of the Think Radial webinar, an educational training session conducted by Merit Medical. The training session was conducted by three experts: Sandeep Nathan, Department of Cardiology, University of Chicago Medicine, Illinois, USA; Darren Klass, Department of Radiology, University of British Columbia, Vancouver, and Department of Radiology, Vancouver General Hospital, British Columbia, Canada; and Ajit Puri, New England Center for Stroke Research, Department of Radiology, University of Massachusetts Medical Center, Worcester, USA, all of whom have a wealth of experience in vascular access. The experts provided valuable insights into topics such as why and how to adopt a dTRA approach, the value of ultrasound for guided vascular access, and dTRA and ultrasound tips and techniques. The experts also explored the challenges in transradial intervention and management of radial access complications. Drawing on their individual specialist knowledge, the experts concluded with presentations on PCI, radial approaches in interventional radiology, and dRA access in neurointervention. The aim of this educational article is to disseminate key information on TRA provided by the experts to guide and update healthcare practitioners, particularly interventional cardiologists and interventional radiologists, working in vascular access.