Key result
This review provides recommendations on optimizing patient selection for transradial and transfemoral access, managing access site crossover, and performing state-of-the-art femoral artery puncture.
Provides recommendations for optimal patient selection and technique for transfemoral access in the era of default transradial access to mitigate the paradoxical increase in vascular complications.
Answers are grounded in this paper and cite their sources.
Paradoxical TFA complication rise post-TRA adoption warrants caution in femoral cases; leaves open optimal training to sustain proficiency.
Transradial access (TRA) has reduced vascular access-site complication (VASC) and bleeding rates in patients undergoing coronary angiography and intervention. A "radial-first" approach should be adopted and indications of TRA extended in order to maximize its beneficial effect. However, in certain clinical scenarios, transfemoral access (TFA) is a preferable or a mandatory route to successfully perform the procedure. Since the widespread adoption of TRA, a paradoxical increase in VASC rates has been observed in patients undergoing TFA, which might be attributed to a combination of increased risk profile of both the procedures and the patients, and a loss of skills in securing TFA by those who are now default radial operators. In the present article we provide recommendations on how to optimize patient selection for TRA and TFA, how to manage access site crossover, and how to perform state-of-the-art femoral artery puncture.
No takes yet. Share an insight, caveat, or question.
Azzalini et al. (2016) conducted a review in Patients undergoing coronary angiography and intervention. Transfemoral access optimization was evaluated. This review provides recommendations on optimizing patient selection for transradial and transfemoral access, managing access site crossover, and performing state-of-the-art femoral artery puncture.
Synapse has enriched 5 closely related papers on similar clinical questions. Consider them for comparative context: