January 15, 2020 — The Society for Cardiovascular Angiography and Interventions (SCAI) released an updated expert consensus statement for the best practices for transradial artery access used for diagnostic angiography and interventional procedures. 
The new document updates the 2013 publication of the “SCAI Best Practices for Transradial Angiography and Intervention,” because the the body of evidence for both the technical aspects of transradial procedures and their application has changed considerably over the past seven years. Notably, several randomized and observational studies have been conducted to address previously unanswered questions described in the initial publication. In response, SCAI convened a panel of experts to summarize the available contemporary data and reach a consensus on how these findings should be translated into clinical practice.
Transradial angiography and intervention continues to become increasingly common as an access site for coronary procedures. SCAI said since the first best practices paper in 2013, ongoing trials have shed further light onto the safest and most efficient methods to perform these procedures. Specifically, this document comments on the use of ultrasound to facilitate radial access, the role of ulnar artery access, the utility of non‐invasive testing of collateral flow, strategies to prevent radial artery occlusion, radial access for primary percutaneous coronary intervention (PCI) and topics that require further study.
In less than a decade there has been explosive growth in the use of transradial access in the patient's wrist over the previous standard of care using femoral artery access in the groin. Use of radial access in the United States, radial access use went from about 5 percent of procedures to about 50 percent, based on data from the American College of Cardiology (ACC) National Cardiovascular Data Registry (NCDR) CathPCI Registry.
Watch the VIDEO: Trends in Radial Access for Percutaneous Coronary Interventions, an interview at TCT 2019 with Sunil Rao, M.D., and Prashant Kaul, M.D.
Watch a VIDEO of the first author Adhir R. Shroff, M.D., explaining the new guidelines at SCAI 2019.
1. Adhir R. Shroff MD, MPH, FSCAI (Chair) Rajiv Gulati MD, PhD, FSCAI (Co‐Chair) Douglas E. Drachman MD, FSCAI Dmitriy N. Feldman MD, FSCAI Ian C. Gilchrist MD, FSCAI, et al. SCAI expert consensus statement update on best practices for transradial angiography and intervention. Catheterization and Cardiovascular Interventions. First published: 27 December 2019 https://doi.org/10.1002/ccd.28672