Advances in Interventional Cardiology
eISSN: 1897-4295
ISSN: 1734-9338
Advances in Interventional Cardiology/Postępy w Kardiologii Interwencyjnej
Current Issue Archive Manuscripts accepted About the journal Editorial board Abstracting and indexing Subscription Contact Instructions for authors Publication charge Ethical standards and procedures
Editorial System
Submit your Manuscript
SCImago Journal & Country Rank
4/2025
vol. 21
 
Share:
Share:
Review paper

Radial artery access in interventional cardiology: a review of current practices

Ameen Nasser
1
,
Alexandra Malkowski
1
,
Anna Żądło
1
,
Mateusz Michalczak
1
,
Artur Dziewierz
2, 3
,
Tomasz Tokarek
1, 4

  1. Center for Innovative Medical Education, Jagiellonian University Medical College, Krakow, Poland
  2. Second Department of Cardiology, Institute of Cardiology, Jagiellonian University Medical College, Krakow, Poland
  3. Clinical Department of Cardiology and Cardiovascular Interventions, University Hospital, Krakow, Poland
  4. Center for Invasive Cardiology, Electrotherapy and Angiology, Nowy Sacz, Poland
Adv Interv Cardiol 2025; 21, 4 (82): 475–486
Online publish date: 2025/12/19
Article file
- radial artery access.pdf  [0.30 MB]
Get citation
 
 
1. Bajraktari G, Rexhaj Z, Elezi S, et al. Radial access for coronary angiography carries fewer complications compared with femoral access: a meta-analysis of randomized controlled trials. J Clin Med 2021; 10: 2163.
2. Mason PJ, Shah B, Tamis-Holland JE, et al. An update on radial artery access and best practices for transradial coronary angiography and intervention in acute coronary syndrome: a scientific statement from the American Heart Association. Circ Cardiovasc Interv 2018; 11: e000035.
3. Ferrante G, Rao SV, Jüni P, et al. Radial versus femoral access for coronary interventions across the entire spectrum of patients with coronary artery disease. JACC Cardiovasc Interv 2016; 9: 1419-34.
4. Valgimigli M, Gagnor A, Calabró P, et al. Radial versus femoral access in patients with acute coronary syndromes undergoing invasive management: a randomised multicentre trial. Lancet 2015; 385: 2465-76.
5. Jolly SS, Yusuf S, Cairns J, et al. Radial versus femoral access for coronary angiography and intervention in patients with acute coronary syndromes (RIVAL): a randomised, parallel group, multicentre trial. Lancet 2011; 377: 1409-20.
6. Dziewierz A, Siudak Z, Tokarek T, et al. Determinants of stroke following percutaneous coronary intervention in acute myocardial infarction (from ORPKI Polish National Registry). Int J Cardiol 2016; 223: 236-8.
7. Tokarek T, Dziewierz A, Plens K, et al. Radial approach expertise and clinical outcomes of percutanous coronary interventions performed using femoral approach. J Clin Med 2019; 8: 1484.
8. Rao SV, Cohen MG, Kandzari DE, et al. The transradial approach to percutaneous coronary intervention. J Am Coll Cardiol 2010; 55: 2187-95.
9. Kiemeneij F, Burzotta F, Fajadet J. Thirty years of transradial coronary interventions. EuroIntervention 2022; 18: 19-21.
10. Nasr AY. The radial artery and its variations: anatomical study and clinical implications. Folia Morphol 2012; 71: 252-62.
11. Byrne RA, Rossello X, Coughlan JJ, et al. 2023 ESC Guidelines for the management of acute coronary syndromes. Eur Heart J 2023; 44: 3720-826.
12. Alasmari WA. The morphometric anatomy and clinical importance of the radial artery. Folia Morphol 2021; 80: 839-44.
13. Narsinh KH, Mirza MH, Duvvuri M, et al. Radial artery access anatomy: considerations for neuroendovascular procedures. J Neurointerv Surg 2021; 13: 1139-44.
14. Zheng Y, Shao L, Mao J. Bilaterally symmetrical congenital absence of radial artery: a case report. BMC Surg 2014; 14: 15.
15. Pelliccia F, Trani C, Biondi-Zoccai GGL, et al. Comparison of the feasibility and effectiveness of transradial coronary angiography via right versus left radial artery approaches (from the PREVAIL Study). Am J Cardiol 2012; 110: 771-5.
16. De Rosa S, Torella D, Caiazzo G, et al. Left radial access for percutaneous coronary procedures: from neglected to performer? A meta-analysis of 14 studies including 7603 procedures. Int J Cardiol 2014; 171: 66-72.
17. Biondi-Zoccai G, Sciahbasi A, Bodí V, et al. Right versus left radial artery access for coronary procedures: an international collaborative systematic review and meta-analysis including 5 randomized trials and 3210 patients. Int J Cardiol 2013; 166: 621-6.
18. Shah RM, Patel D, Abbate A, et al. Comparison of transradial coronary procedures via right radial versus left radial artery approach: a meta-analysis. Catheter Cardiovasc Interv 2016; 88: 1027-33.
19. Sciahbasi A, Romagnoli E, Burzotta F, et al. Transradial approach (left vs right) and procedural times during percutaneous coronary procedures: TALENT study. Am Heart J 2011; 161: 172-9.
20. Dominici M, Diletti R, Milici C, et al. Operator exposure to x-ray in left and right radial access during percutaneous coronary procedures: OPERA randomised study. Heart 2013; 99: 480-4.
21. Tokarek T, Dziewierz A, Plens K, et al. Radial approach reduces mortality in ST-segment elevation myocardial infarction with cardiogenic shock. Pol Arch Intern Med 2021; 131: 421-8.
22. Chiarito M, Cao D, Nicolas J, et al. Radial versus femoral access for coronary interventions: an updated systematic review and meta-analysis of randomized trials. Catheter Cardiovasc Interv 2021; 97: 1387-96.
23. Romagnoli E, Biondi-Zoccai G, Sciahbasi A, et al. Radial versus femoral randomized investigation in ST-segment elevation acute coronary syndrome. J Am Coll Cardiol 2012; 60: 2481-9.
24. Andò G, Cortese B, Russo F, et al. Acute kidney injury after radial or femoral access for invasive acute coronary syndrome management. J Am Coll Cardiol 2017; 69: 2592-603.
25. Rao SV, Hess CN, Barham B, et al. A registry-based randomized trial comparing radial and femoral approaches in women undergoing percutaneous coronary intervention. JACC Cardiovasc Interv 2014; 7: 857-67.
26. Louvard Y, Lefvre T, Allain A, Morice M-C. Coronary angiography through the radial or the femoral approach: the CARAFE study. Catheter Cardiovasc Interv 2001; 52: 181-7.
27. Chodór P, Krupa H, Kurek T, et al. RADIal versus femoral approach for percutaneous coronary interventions in patients with acute myocardial infarction (RADIAMI): a prospective, randomized, single-center clinical trial. Cardiol J 2009; 16: 332-40.
28. Lindner SM, McNeely CA, Amin AP. The value of transradial. Interv Cardiol Clin 2020; 9: 107-15.
29. Coghill EM, Johnson T, Morris RE, et al. Radial artery access site complications during cardiac procedures, clinical implications and potential solutions: the role of nitric oxide. World J Cardiol 2019; 12: 26-34.
30. Pandie S, Mehta SR, Cantor WJ, et al. Radial versus femoral access for coronary angiography/intervention in women with acute coronary syndromes. JACC Cardiovasc Interv 2015; 8: 505-12.
31. Zus AS, Crișan S, Luca S, et al. Radial artery spasm – a review on incidence, prevention and treatment. Diagnostics 2024; 14: 1897.
32. Lavi S, Cheema A, Yadegari A, et al. Randomized trial of compression duration after transradial cardiac catheterization and intervention. J Am Heart Assoc 2017; 6: e005029.
33. Sanghvi KA, Montgomery M, Varghese V. Effect of hemostatic device on radial artery occlusion: a randomized comparison of compression devices in the radial hemostasis study. Cardiovasc Revasc Med 2018; 19: 934-8.
34. Gatzopoulos D, Rigatou A, Kontopodis E, et al. Alternative access site choice after initial radial access site failure for coronary angiography and intervention. J Geriatr Cardiol 2018; 15: 585-90.
35. Basu D, Singh PM, Tiwari A, Goudra B. Meta-analysis comparing radial versus femoral approach in patients 75 years and older undergoing percutaneous coronary procedures. Indian Heart J 2017; 69: 580-8.
36. Andò G, Capodanno D. Radial versus femoral access in invasively managed patients with acute coronary syndrome: a systematic review and meta-analysis. Ann Intern Med 2015; 163: 932-40.
37. Chester RC, Mina SA, Lewis B, et al. Radial artery access is under-utilized in women undergoing PCI despite potential benefits: Mayo Clinic PCI Registry. Catheter Cardiovasc Interv 2020; 95: 675-83.
38. Vora AN, Stanislawski M, Grunwald GK, et al. Association between chronic kidney disease and rates of transfusion and progression to end-stage renal disease in patients undergoing transradial versus transfemoral cardiac catheterization – an analysis from the Veterans Affairs Clinical Assessment Reporting and Tracking (CART) Program. J Am Heart Assoc 2017; 6: e004819.
39. Sutton NR, Seth M, Lingam N, Gurm HS. Radial access use for percutaneous coronary intervention in dialysis patients. Circ Cardiovasc Interv 2020; 13: e008418.
40. Nardin M, Verdoia M, Barbieri L, et al. Radial vs femoral approach in acute coronary syndromes: a meta- analysis of randomized trials. Curr Vasc Pharmacol 2017; 16: 79-92.
41. Cantor WJ, Mehta SR, Yuan F, et al. Radial versus femoral access for elderly patients with acute coronary syndrome undergoing coronary angiography and intervention: insights from the RIVAL trial. Am Heart J 2015; 170: 880-6.
42. Kar S. Systematic review of alternative access for cardiac catheterization and percutaneous coronary intervention: dorsal distal radial and ulnar artery catheterization. Catheter Cardiovasc Interv 2019; 94: 706-13.
43. Cao J, Cai H, Liu W, et al. Safety and effectiveness of coronary angiography or intervention through the distal radial access: a meta-analysis. J Intervent Cardiol 2021; 2021: 4371744.
44. Daralammouri Y, Nazzal Z, Mosleh YS, et al. Distal radial artery access in comparison to forearm radial artery access for cardiac catheterization: a randomized controlled trial (DARFORA Trial). J Intervent Cardiol 2022; 2022: 7698583.
45. Jin C, Li W, Qiao S, et al. Costs and benefits associated with transradial versus transfemoral percutaneous coronary intervention in China. J Am Heart Assoc 2016; 5: e002684.
46. Mamas MA, Tosh J, Hulme W, et al. Health economic analysis of access site practice in england during changes in practice: insights from the British Cardiovascular Interventional Society. Circ Cardiovasc Qual Outcomes 2018; 11: e004482.
47. Mitchell MD, Hong JA, Lee BY, et al. Systematic review and cost–benefit analysis of radial artery access for coronary angiography and intervention. Circ Cardiovasc Qual Outcomes 2012; 5: 454-62.
48. Mahmud E, Madder RD, Wohns DH, et al. Robotic-assisted percutaneous coronary intervention: final results of the PRECISION and PRECISION GRX studies. J Soc Cardiovasc Angiogr Interv 2025; 4: 103655.
49. Snelling BM, Sur S, Shah SS, et al. Transradial access: lessons learned from cardiology. J Neurointerv Surg 2018; 10: 487-92.
50. Riangwiwat T, Mumtaz T, Blankenship JC. Barriers to use of radial access for percutaneous coronary intervention. Catheter Cardiovasc Interv 2020; 96: 268-73.
Copyright: © 2025 Termedia Sp. z o. o. This is an Open Access article distributed under the terms of the Creative Commons Attribution-NonCommercial-ShareAlike 4.0 International (CC BY-NC-SA 4.0) License (http://creativecommons.org/licenses/by-nc-sa/4.0/), allowing third parties to copy and redistribute the material in any medium or format and to remix, transform, and build upon the material, provided the original work is properly cited and states its license.
Quick links
© 2026 Termedia Sp. z o.o.
Developed by Bentus.