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References and Bibliography

The web sites and articles about the transradial approach that are listed below are provided as a service by Angioplasty.Org, which is not responsible for the content found on any external sites. The articles are listed chronologically, with the most recent first. Some of the articles require a subscription to the journal itself in order to access the full-text versions online. All links open in a new browser window.

We welcome additions to this list. Please contact us and we will review them for posting.

Journal and Online Articles

The Transradial Approach: Does your fellowship training program teach it?
Jennifer A. Tremmel, MD, MS of Stanford University Medical Center in Stanford, California
Cardiac Interventions Today
February 2010
Dr. Tremmel surveys the reasons why adoption of the transradial approach has been lagging in the United States -- and demonstrates that a large part of the problem is the lack of fellowship training. She describes the fellowship course at Stanford and gives an excellent overview of the benefits of radial to both patients and young interventional cardiologists just starting out. An added feature is a group of statements from new fellows from around the U.S. who have received training in transradial -- and how it has affected their practice and direction for the future. Also read Dr. Tremmel's interview with Angioplasty.Org.

The role of radial artery access in the evolution of percutaneous angioplasty and in minimizing complications
Martial Hamon, MD, and Javed Ehtisham, MD
Department of Cardiology, University Hospital of Caen in Normandy, France
Cardiac Interventions Today
February 2010
Explores the benefits of the transradial approach to PCI, especially in ACS patients; discusses the increased mortality seen in patients where major bleeding complications have occurred. "The choice of vascular access site for PCI is one of the most important factors in determining bleeding risk."

Transradial approach gains momentum, and for good reason
Cardiovascular Business
Web Only -- January 8, 2010
Features a discussion with Dr. Sunil V. Rao about the state of the transradial approach to catheter-based interventions in the United States. Also read Dr. Rao's interview with Angioplasty.Org.

The Back Page: Transradial Myths Dispelled, Hurdles Conquered—Adopt Now
Cardiovascular Business
Volume 4, No. 1 -- January 2010
Article features comments by Jack J. Hall, MD, director of transradial catheterization, and John Stewart, CEO and president of St. Vincent Heart Center of Indiana in Indianapolis.

Transradial Access:A Look at Education
Cath Lab Digest talks with John T. Coppola, MD, FACC, Chief of Cardiology, Cath Lab Director, St. Vincent’s Hospital, New York, New York
Cath Lab Digest
December 2009 -- Volume 17 - Issue 12
An interview with Dr. Coppola about training and education -- St. Vincent's has been running a transradial training program (and Fellowship) for some time -- many of the current proponents of radial in the U.S. got their training from Dr. Coppola. Also read Dr. Coppola's interview with Angioplasty.Org

Transradial left main stem rotational artherectomy and stenting: case report and literature review
Sandhir B. Prasad, Yuvaraj Malaiapan, Walid Ahmar, Ian T. Meredith (Monash Medical Centre, Australia)
Cardiovascular Revascularization Medicine
Volume 10, Issue 2, Pages 136-139 (April 2009)
Percutaneous coronary interventions (PCI) on complex unprotected left main stem (LMS) lesions involving rotational artherectomy are technically challenging and high risk cases. There is limited experience in performing these cases via a radial approach. We report a case of an unstable patient with severe distal LMS disease in whom cardiac surgery, intra-aortic balloon pumping and femoral approach were all contraindicated, who was successfully treated via a radial approach. We also review the technical challenges of LMS PCI through a radial approach.

Five-year experience with transradial coronary angioplasty in ST-segment-elevation myocardial infarction
Zoltán Ruzsa, Imre Ungi, Tamás Horváth, Róbert Sepp, Zsolt Zimmermann, Attila Thury, Zoltán Jambrik, Viktor Sasi, Gábor Tóth, Tamás Forster, Attila Nemes
Cardiovascular Revascularization Medicine
Volume 10, Issue 2, Pages 73-79 (April 2009)
This retrospective single-center study from the University of Szeged, Hungary was performed to compare the outcomes and complication rates between transradial (TR) and transfemoral (TF) PCI in ST-segment-elevation myocardial infarction (STEMI). The clinical and angiographic data of 582 consecutive STEMI patients treated with PCI were evaluated after excluding 43 patients (due to cardiogenic shock or rescue PCI). 372 patients had been done femorally (TF) and 167 via the transradial approach (TR). Crossover from TR to TF was 5%, from TF to TR was 0.8%. There was a significant difference, in both major and minor access-site complications, between the TR group and the TF group (0% vs. 5%, P<.05, and 4% vs. 9%, P<.05, respectively). The MACE rate was 4% in the TR group and 11% in the TF group (P<.05). Our results suggest that the TR approach is a safe and effective way to treat STEMI; furthermore, site-related complications are less common with this approach.

Ambulatory discharge after transradial coronary intervention: Preliminary US single-center experience (Same-day TransRadial Intervention and Discharge Evaluation, the STRIDE Study)
Refat Jabara, MD, Radhika Gadesam, MD, Lakshmana Pendyala, MD, Nicolas Chronos, MD, FACC, Larry V. Crisco, MD, FACC, Spencer B. King, MD, MACC, Jack P. Chen, MD, FACC
American Heart Journal
Volume 156, Issue 6, Pages 1141-1146 (December 2008)
Conclusions: Although a low incidence of complications did occur, none would have been impacted by same-day discharge. Those observed before 6 hours would have prevented early discharge, and those occurring after 24 hours would have been unaffected by routine next-day discharge. This observational study demonstrated the safety and feasibility for a prospective evaluation of ambulatory TR-PCI in an American practice setting.

Presentation on Transradial Angioplasty at 8th Annual Meeting of the Japanese Association of Cardiovascular Catheter Therapeutics
Thierry Lefevre, MD
Published Online: December 3, 2008
Dr. Lefevre's PowerPoint Presentation is available online in PDF format.

Transradial versus transfemoral approach for coronary angiography and intervention in patients above 75 years of age
Stephan Achenbach, MD, Dieter Ropers, MD, Lisa Kallert, MD, Nesrin Turan, MD, Robert Krähner, MD, Tobias Wolf, MD, Christoph Garlichs, MD, Frank Flachskampf, MD, Werner G. Daniel, MD, Josef Ludwig, MD
Catheterization and Cardiovascular Interventions
Volume 72 Issue 5, November 1, 2008, Pages 629 - 635

First Published Online: 23 July 2008
Conclusion: Our trial clearly demonstrates that routine use of the TR approach for coronary angiography and intervention in patients at advanced age has a high clinical success rate and can be performed without substantial disadvantages concerning procedural duration, radiation exposure, use of contrast agent, or other resources such as catheters. However, it is associated with a substantially lower rate of complications as compared to the TF approach and a more widespread use of the TR route, especially in patients at increased risk for vascular complications, should be strongly encouraged.

Prevention of radial artery occlusion: Patent hemostasis evaluation trial (PROPHET study): A randomized comparison of traditional versus patency documented hemostasis after transradial catheterization
Samir Pancholy, John Coppola, Tejas Patel, Marie Thomas
Catheterization and Cardiovascular Interventions
Volume 72 Issue 3, September 1, 2008, Pages 335 - 340

First Published Online: 14 May 2008
Conclusion: Patent hemostasis is highly effective in reducing radial artery occlusion after radial access; guided compression should be performed to maintain radial artery patency at the time of hemostasis, to prevent future radial artery occlusion.

Trends in the Prevalence and Outcomes of Radial and Femoral Approaches to Percutaneous Coronary Intervention: A Report From the National Cardiovascular Data Registry (NCDR)
Sunil V. Rao, MD, FACC, Fang-Shu Ou, MS, Tracy Y. Wang, MD, MS, Matthew T. Roe, MD, MHS, FACC, Ralph Brindis, MD, MPH, FACC, John S. Rumsfeld, MD, PhD, FACC, Eric D. Peterson, MD, MPH, FACC
JACC Cardiovascular Interventions
Volume 1, Issue 4, August 2008
J Am Coll Cardiol Intv, 2008; 1:379-386, doi:10.1016/j.jcin.2008.05.007
Conclusion: The use of radial PCI is rare in contemporary clinical practice, but it is associated with a rate of procedural success similar to the femoral approach and with lower rates of bleeding and vascular complications, even among high-risk groups. These results suggest that wider adoption of radial PCI (r-PCI) in clinical practice may improve the safety of PCI.

Is radial approach the gold standard for PCI?
Martial Hamon and Jim Nolan
HEART (BMJ) -- Published Online First: 31 July 2008

This Editorial, appearing in the same edition of "Heart" as the M.O.R.T.A.L. study (below) posits the scenario of a 65 year old patient hospitalized with a troponin positive acute coronary syndrome (ACS) who is initially managed with intensive antithrombotic therapy. Despite a successful complicated kissing balloon procedure (performed from the femoral approach) the patient was observed a day later with low blood pressure and groin discomfort: an extensive hematoma which required a blood transfusion and vascular surgical repair. The editorial asks if this is a rare, inconvenient, benign and unavoidable component of contemporary ACS management or if the radial approach might be the preferred access for PCI, since the M.O.R.T.A.L. study shows that radial artery access can halve bleeding complications.

The Association Of Arterial Access Site At Angioplasty With Transfusion And Mortality The M.O.R.T.A.L Study: (Mortality benefit of Reduced Transfusion After PCI via the Arm or Leg)
Alex J Chase, Eric B Fretz, William P Warburton, W Peter Klinke, Ronald G Carere, David Pi, Brian Berry and J David Hilton
HEART (BMJ) -- Volume 94 Number 8, August 2008

In a registry of all-comers to PCI, we analysed 38,872 procedures in 32,822 patients in British Columbia. Trans-radial access was associated with a halving of transfusion rate and a reduction in 30 day and 1 year mortality.

Safety and feasibility of transradial approach for primary percutaneous coronary intervention in elderly patients with acute myocardial infarction
YAN Zhen-xian, ZHOU Yu-jie, ZHAO Ying-xin, LIU Yu-yang, SHI Dong-mei, GUO Yong-he, CHENG Wan-jun
May 5, 2008
Chinese Medical Journal, 2008, Vol. 121 No. 9 : 782-786
Results: Between the two groups -- transradial (TRI) and transfemoral (TFI) -- which totalled 103 consecutive patients older than 64 years, there were no significant differences in the success rates of puncture and PCI, puncture time, cannulation time, reperfusion time, total time of the procedure, use rates of temporary pacemaker and IABP, or MACE. However, the hospital stay of the transfemoral group was longer than that of the transradial group ((10.1±4.6) vs (7.2±2.6) days, P<0.01). As for complications, a radial occlusion was observed in the TRI group, but no ischemic syndrome in hand. In the TFI group, 4 patients had hematosis, 1 had pseudoaneurysm, and 1 had major bleeding. Statistical significance in vascular access site complications was seen in the two groups (1.8 % vs 13.1%, P<0.05).
Conclusion: The transradial approach for primary PCI is safe and feasible for elderly patients with AMI.

Major Femoral Bleeding Complications After Percutaneous Coronary Intervention: Incidence, Predictors, and Impact on Long-Term Survival Among 17,901 Patients Treated at the Mayo Clinic From 1994 to 2005
Doyle, Brendan J., Ting, Henry H., Bell, Malcolm R., Lennon, Ryan J., Mathew, Verghese, Singh, Mandeep, Holmes, David R., Rihal, Charanjit S.
JACC: Cardiovascular Interventions
April 2008
J Am Coll Cardiol Intv 2008 1: 202-209
A retrospective single-center study of almost 18,000 patients at the Mayo Clinic from 1994-2005 showed a marked decline in the incidence of major femoral bleeding after PCI over the past decade (from 8.4% to 5.3% to 3.5%). However, the authors note, mortality associated with these bleeding complications and with blood transfusion remains a significant issue.

Predictors of outcome in patients undergoing PCI. Results of the RIVIERA study
Montalescot G, Ongen Z, Guindy R, Sousa A, Lu SZ, Pahlajani D, Pellois A, Vicaut E; for the RIVIERA Investigators
International Journal of Cardiology
December 3, 2007 [Epub ahead of print]
Radial access, thienopyridine pretreatment and anticoagulation with enoxaparin were associated with a lower risk of death or MI. Female gender, PCI of coronary artery bypass graft, administration of a GP IIb/IIIa inhibitor and combined use of enoxaparin and unfractionated heparin were significantly associated with more bleeding. Radial access was the only variable associated with less bleeding.

Transradial Access in an Occluded Radial Artery: New Technique
Samir B. Pancholy, MD
Journal of Invasive Cardiology
December 2007
published as a Rapid Communication
We have now attempted radial access in 14 patients with documented radial artery occlusion and succeeded in 12 of these patients. We describe a representative case where radial access was successfully obtained in an occluded radial artery proven by ultrasonography or angiography. We also report the histopathologic findings of the occlusion-causing material extracted from the sheath.

Reconsideration of the Transradial Approach for PCI (PDF)
Ronald. P. Caputo, MD, FACC, FSCAI
Cardiac Interventions Today
December 2007
The Transradial approach fro PCI eliminates access site bleeding complications which may pose the largest risk to patients undergoing PCI in the modern era

Essential Technical Components of the Transradial Approach
Ronald. P. Caputo, MD, FACC, FSCAI
Cath Lab Digest
September 2007
ISSN: 1073-2667 - Volume 15 - Issue 09 - September 2007 - Pages: 38 - 39
Objective: Compelling reasons to consider transradial catheterization include the virtual elimination of bleeding complications, more efficient patient throughput, patient preference and possible economic advantages.

Comparative study of nicorandil and a spasmolytic cocktail in preventing radial artery spasm during transradial coronary angiography
Kim SH, Kim EJ, Cheon WS, Kim MK, Park WJ, Cho GY, Choi YJ, Rhim CY
International Journal of Cardiology
Volume 120, Issue 3, 3 September 2007, Pages 325-330
Radial artery spasm is one of the most common complications during coronary angiography via the transradial approach, causing patient discomfort or sometimes interrupting the procedure. This study was designed to compare the spasmolytic effect between nicorandil and a cocktail during transradial coronary angiography. Conclusion: Nicorandil with vasodilator effects by a dual mechnism was effective as the cocktail in preventing radial artery spasm during transradial coronary angiography.

Cost-Effectiveness of the Radial versus Femoral Artery Approach to Diagnostic Cardiac Catheterization
Oleg Roussanov, MD, S. Jeanne Wilson, RN, Katherine Henley, FNP, Greta Estacio, FNP, Judith Hill, FNP, Brenda Dogan, RN, William F. Henley, PhD, Nabil Jarmukli, MD
Journal of Invasive Cardiology
August 2007
J Invasive Cardiol. 2007 Aug;19(8):349-53
Objective: A single-center experience to determine the cost effectiveness of the radial artery approach to diagnostic cardiac catheterization compared with femoral artery approach in two groups; one with and one without utilization of a vascular closure device.

Commentary: Cost-effectiveness of Transradial Coronary Access
Ferdinand Kiemeneij, MD, PhD
Journal of Invasive Cardiology
August 2007
J Invasive Cardiol. 2007 Aug;19(8):354 - 354

Transradial approach for noncoronary angiography and interventions
Takenori Yamashita, MD, Shigeki Imai, MD, Tsutomu Tamada, MD, Akira Yamamoto, MD, Naoto Egashira, MD, Shigeru Watanabe, MD, Hiroki Higashi, MD, Masayuki Gyoten, MD
Catheterization and Cardiovascular Interventions
Published Online: 13 Jul 2007
Catheterization and Cardiovascular Interventions 70: 303-308 (2007)
Conclusion: The transradial approach was useful for non-coronary angiography and interventions and offers the advantages of low risk and reduced stress on patients.

Day procedure intervention is safe and complication free in higher risk patients undergoing transradial angioplasty and stenting. The discharge study
Andrew Small, MBBS, Peter Klinke, MD, Anthony Della Siega, MD, Eric Fretz, MD, David Kinloch, MD, Richard Mildenberger, MD, Malcolm Williams, MD, David Hilton, MD
Catheterization and Cardiovascular Interventions
published online July 9, 2007
Catheterization and Cardiovascular Interventions 70: 907-912 (2007)

Alternate Route — Comparing Radial and Femoral Access
Dan Harvey, Radiology Today
May 21, 2007
Vol. 8 No. 10 P. 30

Editorial -- The Case for Outpatient Coronary Intervention: Balancing Charges and Discharges
Frederic S. Resnic, MD, MSc

May 1, 2007
(Circulation. 2007;115:2248-2250.)

Interruption of Blood Flow during Compression and Radial Artery Occlusion after Transradial Catheterization
Marcelo Sanmartin, PhD, FESC, Manica Gomez, RN, Jose Ramon Runoroso, MD, Mario Sadaba, MD, Maite Martinez, RN, Jose Santonio Baz, MD, and Andres Iniguez, PhD, FESC
Catheterization and Cardiovascular Interventions
published online January 3, 2007
Catheterization and Cardiovascular Interventions 70: 185-189 (2007)
Objective: "To analyze the possible relationship between compression after transradial catheterization and radial artery occlusion".

The Effect of a Eutectic Mixture of Local Anesthetic Cream on Wrist Pain during Transradial Coronary Procedures
Jang-Young Kim, MD, Junghan Yoon, MD, PhD, Byung-Su Yoo, MD, Seung-Hwan Lee, MD, Kyung-Hoon Choe, MD
Journal of Invasive Cardiology
January 2007
J Invasive Cardiol. 2007 Jan;19(1):6-9
Conclusion: EMLA-C can be effective in reducing wrist pain during transradial coronary procedures (TRCP) without any significant drug-related complications when the application time is 1 to 3 hours before the procedure.

Randomized Trial Comparing Same-Day Discharge With Overnight Hospital Stay After Percutaneous Coronary Intervention: Results of the Elective PCI in Outpatient Study (EPOS)
Gerlind S. Heyde, MD; Karel T. Koch, MD, PhD; Robbert J. de Winter, MD, PhD; Marcel G.W. Dijkgraaf, PhD; Margriet I. Klees, RN; Lea M. Dijksman, MSc; Jan J. Piek, MD, PhD; Jan G.P. Tijssen, PhD
December 12, 2006
(Circulation. 2006;114:2636-2643.) Dec 12, 2006

A Randomized Study Comparing Same-Day Home Discharge and Abciximab Bolus Only to Overnight Hospitalization and Abciximab Bolus and Infusion After Transradial Coronary Stent Implantation
Olivier F. Bertrand, MD, PhD; Robert De Larochellière, MD; Josep Rodés-Cabau, MD; Guy Proulx, MD; Onil Gleeton, MD; Can Manh Nguyen, MD; Jean-Pierre Déry, MD, MSc; Gérald Barbeau, MD; Bernard Noël, MD; Éric Larose, DVM, MD; Paul Poirier, MD, PhD; Louis Roy, MD, for the Early Discharge After Transradial Stenting of Coronary Arteries (EASY) Study Investigators
December 12, 2006
(Circulation. 2006;114:2578-2580.)

Bleeding complications in patients with acute coronary syndrome undergoing early invasive management can be reduced with radial access, smaller sheath sizes, and timely sheath removal
Warren J. Cantor, MD, Kenneth W. Mahaffey, MD, Zhen Huang, MS, Pranab Das, MD, Dietrich C. Gulba, MD, Stanislav Glezer, MD, Richard Gallo, MD, John Ducas, MD, Marc Cohen, MD, Elliott M. Antman, MD, Anatoly Langer, MD, Neal S. Kleiman, MD, Harvey D. White, MD, Robert J. Chisholm, MD, Robert A. Harrington, MD, James J. Ferguson, MD, Robert M. Califf, MD, Shaun G. Goodman, MD
Catheterization and Cardiovascular Interventions
published online November 30, 2006
Catheterization and Cardiovascular Interventions 69: 73-83 (2006)
Objective: Utilizing procedural data from the SYNERGY trial to determine the impact of the procedural access site, sheath size and timely sheath removal on bleeding complications in patients with acute coronary syndrome.

Editorial: Risk of Bleeding after Elective Percutaneous Coronary Intervention
William W. O'Neill, M.D.
New England Journal of Medicine
September 7, 2006
Volume 355:1058-1060 September 7, 2006 Number 10

Letters to the Editor: Use of the Allen's Test and Transradial Catheterization
David Hildick-Smith, MD
Journal of the American College of Cardiology
Published online August 25, 2006
J Am Coll Cardiol, 2006; 48:1287, doi:10.1016/j.jacc.2006.06.022
Objective: There is no evidence that a normal Allen's test is required for the safe undertaking of a transradial procedure.

Vascular access site complications after PCI: current status and future directions
Martial Hamon, MD
Nature Clinical Practice Cardiovascular Medicine
August 2006 -- Vol 3 No 8
Objective: Major bleeding is the most common noncardiac complication after percutaneous coronary intervention for coronary artery disease. The reduction of vascular access site complications in PCI procedures is, therefore, a critical challenge. In this month's Viewpoint, Martial Hamon discusses why an alternative access site is needed and compares the benefits of the transradial approach with those of the femoral approach.

Radial Artery Diameter and Vasodilatory Properties After Transradial Coronary Angiography
Erik Madssen, RF, Petter Haere, MD, Rune Wiseth, MD, PhD
Annals of Thoracic Surgery
June 2006
Ann Thorac Surg 2006;82:1698-1702
Objective: The radial artery is proposed as an alternative conduit in coronary revascularization.

Routine Transradial Coronary Angiography in Unselected Patients
Henning Bagger, MD, Jens Hedegaard Kristensen, MD, Per Dahl Christensen, MD, Ib Christian Klausen, MD
The Journal of Invasive Cardiology
March 2005
ISSN: 1042-3931 - Volume 17 - Issue 03 - Pages: 139 - 141
Objective: To measure and compare the results of changing from routine transfemoral to routine transradial coronary angiography performed by a single operator.

Risk factors for the development of retroperitoneal hematoma after percutaneous coronary intervention in the era of glycoprotein IIb/IIIa inhibitors and vascular closure devices
Farouque HM, Tremmel JA, Raissi Shabari F, Aggarwal M, Fearon WF, Ng MK, Rezaee M, Yeung AC, Lee DP.
Journal of the American College of Cardiology
February 2005
J Am Coll Cardiol 2005 45: 363-368
Published in 2005, this retrospective analysis of 3,508 consecutive patients undergoing PCI at Stanford yielded 26 cases of retroperitoneal hematoma (RPH). Randomized studies previously had indicated that vascular access site injury resulting in major bleeding occurred 1-2%, although in unselected patients, the rate was considerably higher. RPH is one of the most serious complications after PCI because it can result in significant blood loss before it is recognized, increasing morbidity and mortality.
In this study the incidence of RPH was 0.74%. Independent predictors of RPH were female gender, low body surface area and higher femoral artery puncture (OR 5.3, p = 0.013). There was no association between RPH and arterial sheath size, use of glycoprotein IIb/IIIa inhibitors, or deployment of a vascular closure device.

Commentary -- Transradial Catheterization: The Road Less Traveled
Nitin Barman, MD, John H. Chiu, MD, Stephen G. Ellis, MD
The Journal of Invasive Cardiology
November 2004
ISSN: 1042-3931 - Volume 16 - Issue 11 (Nov 04) - November 2004 - Pages: 639 - 640

Transradial Subclavian and Coronary Stenting in a Single Procedure
Frances Wood, MD, J. Tift Mann, III, MD, R. Lee Jobe, MD, Michael Arrowood, PA-C
The Journal of Invasive Cardiology
October 2004
ISSN: 1042-3931 - Volume 16 - Issue 10 (October 04) - October 2004 - Pages: 596 - 598
Objective: The transradial approach is a useful technique in patients undergoing percutaneous coronary intervention.

Radial artery access for coronary angiography and percutaneous coronary intervention
R Andrew Archbold, Nicholas M Robinson, Richard J Schilling
British Medical Journal
August 21, 2004
BMJ 2004;329(7463):443 (21 August), doi:10.1136/bmj.329.7463.443

Radial Versus Femoral Approach for Percutaneous Coronary Diagnostic and Interventional Procedures: Systematic Overview and Meta-Analysis of Randomized Trials
Pierfrancesco Agostoni, MD, Giuseppe G. L. Biondi-Zoccai, MD, M. Luisa De Benedictis, MD, Stefano Rigattieri, MD, Marco Turri, MD, Maurizio Anselmi, MD, Corrado Vassanelli, MD, Piero Zardini, MD, Yves Louvard, MD, Martial Hamon, MD (Verona, Rome, and Novara, Italy; and Massy and Caen, France)
Journal of the American College of Cardiology
July 21, 2004

J Am Coll Cardiol 2004:349–56
The radial approach for coronary procedures appears as a safe alternative to femoral access. Moreover, radial access virtually eliminates local vascular complications, thanks to a time-sparing hemostasis technique. However, gaining radial access requires higher technical skills, thus yielding an overall lower success rate. Nonetheless, a clear ongoing trend toward equalization of the two procedures, in terms of procedural success, is evident through the years, probably due to technologic progress of materials and increased operator experience..

Transradial Access for Coronary Angiography and Angioplasty: A Novel Approach (PDF)
V Y T Lim, C N S Chan, V Kwok, K H Mak, T H Koh
Singapore Medical Journal
Singapore Med J 2003 Vol 44(11) : 563-569

Anomalous Origin of Right Radial Artery as a Cause of Radial Approach Failure of Coronary Angiography (PDF)
John Gourassas, Usama Albedd, Christodoulos E. Papadopoulos, Georgios Louridas
January 2003
Hellenic J Cardiol 44: 226-229, 2003

Transradial Approach for Diagnostic Selective Cerebral Angiography: Results of a Consecutive Series of 166 Cases
Yasushi Matsumoto, Kazuhiro Hongo, Toshihide Toriyama, Hisashi Nagashima and Shigeaki Kobayashi
April 2001
American Journal of Neuroradiology 22:704-708 (4 2001)

Radial Artery Access for Diagnostic and Interventional Procedures (PDF)
Steven L. Almany, MD, FACC, William W. O'Neill, MD, FACC
1999 by Accumed Systems,
Ann Arbor, Michigan

Transradial cardiac catheterization: Is femoral access obsolete?
Charanjit S. Rihal, MD, David R. Holmes Jr, MD
American Heart Journal
September 1999

Volume 138, Issue 3, Pages 392-393

Ask the Expert: Benefits of transradial access
Terumo Medical Corporation
Executive Healthcare Management
Objective: Coronary interventions have become a more-widespread, preferred solution for the treatment of cardiovascular disease.


Other Web Sites

Radial Force Group
The European web site of the group that pioneered the radial approach.
Formerly, the web site started by Dr. Tejas Patel, who introduced the radial technique to India, and whose team runs the annual TRICO radial course.