Studies over the past two decades have shown that transradial access for PTCA interventions to have an advantage over transfemoral. Specifically, that access-site and bleeding complications are nearly eliminated. This was an important advantage because although there have been advances in interventional techniques, antithrombotic therapy, and closure devices, bleeding complications continue to be a significant source of mortality and morbidity in these patients. However, recent data suggests another concern that should be considered when choosing the best interventional approach.
The Study Findings
A study published in the Journal of Cardiac Surgery indicates that transradial cardiac catheterization could cause permanent damage to blood vessels. Researchers combed through data from PubMed looking for studies that explored the effects of the procedure. Then a review of 12 eligible studies, published over the last several decades led researchers to the conclusion that transradial catheterization may have a long-lasting and detrimental effect on the radial artery and surrounding tissue for months after surgery. Some of these cells never recover, the authors found.
Other Contributing Factors
A notable reduction in endothelium-dependent cell response was observed in all instances of transradial catheterization. However, deeper analysis of the data uncovered contributing factors such as the female gender and less length of time after the procedure before symptoms were linked to increased vessel dysfunction.
Questions Going Forward
Should these findings also limit the use of the radial artery access during surgeries, like coronary artery bypass grafting, because of the poor endothelial outcome? Should transradial procedures be avoided in women?
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