‘This trend is encouraging’: Radial access for PCI now preferred in US
More and more cardiologists are turning to radial access when performing percutaneous coronary intervention (PCI). In fact, according to new research published in European Heart Journal, radial access is now more common during PCI cases performed in the United States than femoral access.[1]
The study’s authors noted that U.S. care teams have “lagged significantly behind much of the rest of the world” when it comes to embracing the use of radial access. To see if any progress has been made in that area, the group explored the American College of Cardiology’s NCDR CathPCI Registry, focusing on more than 6.6 million PCIs performed in the United States between 2013 and 2022. The median patient age was 66 years old, 31.8% of patients were women and 84.1% were white.
Overall, 40.4% of PCIs performed during that time used radial access. The percentage of PCIs that used radial access skyrocketed over time, going from 20.3% of PCIs in 2013 to 57.5% in 2022, a 2.8-fold increase.
Tracking PCI outcomes with radial vs. femoral access
The authors also evaluated patient outcomes by tracking data from more than 2.2 million PCI cases performed from 2018 to 2022. Overall, radial access was associated with lower rates of in-hospital death, major access site bleeding and other vascular complications than femoral access. However, radial access was linked to a higher rate of ischemic stroke among PCI patients.
Hospital lengths of stay were comparable between the two treatment groups, researchers added, but radial access patients were more likely to be discharged to home.
“An increase in the use of transradial PCI was observed in all geographic regions in the USA and across the clinical spectrum of patients undergoing PCI,” wrote first author Reza Fazel, MD, a cardiologist with Beth Israel Deaconess Medical Center, and colleagues. “This trend was particularly prominent among patients with STEMI, in whom the largest absolute and relative increases in the use of radial access site and the greatest clinical benefit were observed. This trend is encouraging, particularly in light of the accumulating evidence for the greater safety of radial vs femoral access site.”
The group also noted that there is still room for cardiologists to perform even more PCI cases using a radial access site.
“To further optimize PCI outcomes in the USA, further educational strategies and policies to promote use of radial access site in suitable patients are warranted,” Fazel et al. concluded.
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Michael has more than 19 years of experience as a professional writer and editor. He has written at length about cardiology, radiology, artificial intelligence and other key healthcare topics.