Transradial coronary angiography and PCI seems to be everywhere these days. Pick up a cardiac journal, visit various cath-related websites, and you cannot escape being inundated with industry ads, articles on technique, and workshops offered at various conferences.

Data from the American College of Cardiology’s National Cardiovascular Data Registry (NCDR) shows that currently, radial access is extremely rare in United States practice (1.32% of procedures done through the radial artery). However, in many European countries (such as France, Italy, and Spain) radial access is not only common, it is becoming the preferred route, not just when femoral arterial disease and obesity hinder vascular access. Just to our north, it is estimated that nearly 50% of cases are done radially in Canada; Norway and China are leading the way with 80-90% radial access.

There are many pluses and minuses to either femoral or radial access. One is that radial access may limit specialty device selections for complex disease. Radial access allows for immediate sheath removal, diagnostic or PCI, no matter what anticoagulation regimen was used.

Is this another passing fad, or the next “revolution” in our practice? I know if I was the patient, I would be much more comfortable with a needle to my wrist than to my groin.