TDNet Discover

Percutaneous coronary intervention (PCI) has proven to be the most effective acute intervention for patients suffering from myocardial infarctions (MI) and coronary artery disease (CAD) to prevent lasting injury to myocardial tissue. Such procedures have classically been performed utilizing the femoral artery approach. However, concerns with bleeding from the insertion site have remained despite technological advancement. As a result, clinicians have sought a better alternative that reduced post-procedural complications. The radial artery has appeal in this aspect as it is smaller in caliber and under reduced pressures, meaning access site bleeding would be easier to control and less detrimental to patient outcomes. The objective of this study is to determine whether femoral artery or radial artery access is superior in all patients undergoing PCI. To do this, we examined the available evidence, including studies that focused primarily on patients suffering from acute MI as well as undergoing elective PCI for CAD. We limited our focus to studies conducted within the last ten years and obtained the highest level of evidence available. We found that radial artery access is associated with fewer access site complications, reduced patient mortality, and fewer vascular complications when compared with femoral artery access. However, confounding variables included physician training as cannulation of the radial artery requires additional training as it is more anatomically complex to navigate than the femoral artery. Despite such, when variability is accounted for, radial artery access is superior to femoral artery access for patients undergoing PCI as it leads to reduced mortality and improved overall outcomes.