Over the past decade in the United States, there has been growing interest in transradial artery percutaneous access as a way to significantly reduce bleeding rates and access site complications. However, adoption in the United States has been slow compared to other parts of the world, partly due to lack of training in interventional programs until recently. In articles and sessions at various cardiology conferences, I have heard varying U.S. adoption rate percentages.  

In the current era of healthcare reform and increasing requirements to follow appropriate use criteria, any technology that offers a basic yes or no answer to whether a patient should be treated or tested may have a major impact on healthcare. Fractional flow reserve (FFR) is a poster child example of this type of technology, which eliminates intra-observe variability and physician intuition and replaces it with a straightforward index based on clinical evidence. However, while FFR offers an accurate diagnostic tool to provide functional data that the human eye alone cannot see, its use has been limited by its cost and the time it takes to perform. 

A recent review of data from the CathPCI Registry, part of the American College of Cardiology’s (ACC) National Cardiovascular Data Registry (NCDR), offers some insight into average, real-world D2B times.[1] For STEMI patients who arrived at an angioplasty-capable hospital, the average time from hospital arrival to treatment was 64.5 minutes. For patients requiring transfer to another hospital, the average time from arrival at the first hospital to treatment was 121 minutes.