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Canadian Journal of Cardiology

Time to ditch transfemoral access for complex percutaneous coronary intervention?

  • Lorenzo Azzalini
    Correspondence
    Corresponding author: Lorenzo Azzalini, MD PhD MSc, Director, Interventional Cardiology Research, Associate Professor of Medicine, Division of Cardiology, Department of Medicine, University of Washington Medical Center, 1959 NE Pacific St, Box 356422, Seattle, WA 98195, Phone: +1 206-685-9955 · Fax: +1 206-598-3037
    Affiliations
    Division of Cardiology, Department of Medicine, University of Washington, Seattle, WA, USA
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      Few topics in interventional cardiology have received more fervent study than the radial-vs-femoral debate. There is now overwhelming evidence that transradial access (TRA) is associated with lower incidence of vascular complications and bleeding in patients undergoing percutaneous coronary intervention (PCI), and even mortality in the context of acute coronary syndromes (ACS)(
      • 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.
      ,
      • 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.
      ). For this reason, TRA is recommended as the default access route for PCI by guidelines(
      • Neumann F.-J.
      • Sousa-Uva M.
      • Ahlsson A.
      • et al.
      2018 ESC/EACTS guidelines on myocardial revascularization.
      ,
      • Lawton J.S.
      • Tamis-Holland J.E.
      • Bangalore S.
      • et al.
      2021 ACC/AHA/SCAI Guideline for coronary artery revascularization.
      ).
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