Accessing the Wrist: From Data to Tips and Tricks

Abstract

Over the past 2 decades, radial artery access has increasingly become the standard approach for coronary angiography and intervention. Compared with femoral arteries, transradial access is associated with better hemostasis. Transradial access has increased patient preference, facilitates early ambulation, and is cost-effective. An important limitation of transradial access is access site failure, and it carries a crossover rate of 3% to 7% in randomized prospective trials comparing radial with femoral artery access among experienced operators. Crossover rates for failed primary radial artery access can be reduced with ultrasonography guidance and increased familiarity with alternative access sites in the wrist.

Keywords: Coronary artery disease; Distal radial artery access; Left radial artery access; Percutaneous coronary intervention; Transfemoral access; Transradial access; Transulnar access; Ultrasound guided access.