Radial access is very popular outside the United States because it offers improved safety, comfort and cost savings over femoral access, which is the current U.S. standard of care. Femoral access site recovery usually involves heavy, uncomfortable compression of the leg. Patients are also required to lay on their back, in bed and not move for hours to ensure proper hemostasis. These discomforts are eliminated with radial access.
Most importantly, the risk of bleeding and arterial damage, the most common complications following these procedures, is essentially eliminated with the transradial approach, said Jack P. Chen, M.D., FACC, FSCAI, FCCP, director of cardiac research, St. Joseph’s Translational Research Institute, Saint Joseph’s Heart and Vascular Institute, Atlanta. He also directs a course to train cardiologists on the transradial technique.
“If you talk to any patient who has gone through a transfemoral procedure, they will tell you the worst thing is after the procedure. That’s what patients dread the most,” Chen told Diagnostic and Invasive Cardiology. “Most patients complain of the bed rest, the back pain, muscle spasms and the tremendous amount of pressure applied to their groin by a clamp or a staff member. You can spend three hours performing a complex, multidevice, multivessel bifurcation rotablator/stent case with an excellent result, but what the patient will remember is the pain from the pseudoaneurysm repair they now need.”
Radial access eliminates this vascular access risk, as well as the pain and discomfort associated with hours of bed rest, Chen said. “There is no question patients prefer this,” Chen explained.
With patients who have undergone both radial and femoral access procedures, Chen said the vast majority will never let him touch their legs again. This type of patient satisfaction has spread by word of mouth and has led to an increasing number of patients seeking radial access procedures at St. Joseph’s. “My patients are the procedure’s and my best advocates,” Chen said.
In March 2010, St. Joseph's Hospital of Atlanta opened the first transradial access recover lounge in the United States. It replaces beds with chairs and patients are encouraged to walk around, get coffee, check their e-mail and read.