November 13, 2013 — The Society for Cardiovascular Angiography and Interventions (SCAI) published a first-of-its-kind paper defining best practices for the use of the transradial approach for diagnosing and treating blocked heart arteries. Published online in Catheterization and Cardiovascular Interventions (CCI), the recommendations aim to ensure high-quality patient care as transradial access becomes the preferred technique for catheter-based procedures. Studies show a decreased risk for bleeding and vascular complications, increased patient satisfaction and reduced costs when the transradial approach is used.
“While there are a number of benefits to transradial over transfemoral approaches, there are risks associated with any procedure. By emphasizing proper training and highlighting best practices, we aim to ensure that patients receive the advantages of this approach while minimizing any potential complications,” said Sunil Rao, M.D., FSCAI, associate professor of medicine, Duke University and lead author of the consensus statement.
In developing this statement, SCAI focused on three core areas to guide physicians:
Best practices for avoiding blocked blood flow to the radial (wrist) artery:
Patients should be assessed prior to discharge and at the first post-procedure visit to avoid the potential for radial artery occlusion (RAO), where blood flow to the artery is blocked. Extra care also should be taken to ensure patients receive all relevant strategies for prevention of RAO.
Best practices for reducing potential radiation exposure to patient and operators:
To reduce the risk of exposure to radiation during a transradial procedure, the patient’s accessed arm should be placed next to his or her torso. Additional extension tubing should be used and operators should be cognizant of safe radiation protocols.
Best practices for physicians transitioning to the transradial approach when treating heart attack:
Studies have shown benefits when patients suffering a heart attack undergo angioplasty via the wrist. Steps must be taken to ensure physicians have mastered the technique before performing emergency cases routinely from the wrist. This learning process includes understanding when to revert to access through the femoral (groin) artery and how to ensure that using the radial approach does not result in delayed treatment or increased door-to-balloon time.
Fore more information: www.scai.org