Today’s report from the ACC CathPCI Registry data has some interesting statistics, among them a significant increase in the transradial approach, in which balloons and stents are directed to the heart via the radial artery in the wrist. As I’ve discussed for several years now, the radial approach is utilized much more outside of the U.S. — but it is catching on here…finally.
Four years ago we wrote about a study, authored by Dr. Sunil V. Rao, that also used data from the CathPCI registry for the years 2004-2007. (For more information, read my interview with Dr. Rao.) At that time Dr. Rao calculated the usage of transradial angioplasty in the U.S. at 1.32%.
Today’s report tabulates it at 6.9%: a five-fold increase!
Dr. Rao has been one of the main proponents of the transradial approach in the U.S., practicing it, teaching it, lecturing all over the country about it, and most recently co-directing a “Masters Course” in transradial at Duke. So I asked Dr. Rao for his comments on today’s study, which follow:
“I think the increase in radial has surprised everyone, especially since it is not a ‘new’ technique. The clinical community has embraced it because of the data validating its superiority with respect to reducing vascular complications and, anecdotally, patients are coming in asking for radial approach. Educationally, we and others, like SCAI, are meeting the demand for training, and this was hugely lacking in the past. My guess is that radial will continue to grow. I am not sure where we will end up, but as the new generation of interventional trainees go into practice, it may grow at rate that surprises everyone. I also predict that we will be seeing more and more data on different aspects of radial approach. To that end, there will be two issues of the American Heart Journal dedicated to radial papers – one coming out in a few weeks, and another in early 2013.”
Dr. Rao believes that the adoption of radial has increased substantially since the latest tabulation…and the math would tend to bear this out. Virtually all the “radialists” (interventional cardiologists who have adopted the procedure) I’ve talked with do at least 50% of their procedures via the wrist; most do 80-90% that way. So for every single cardiologist who adopts this approach, hundreds of procedures annually become “transradial.” The math alone implies a steep exponential upward curve.
More data about the use of the transradial approach in the treatment of heart attacks will be reported at next week’s TCT meeting in Miami. Also the entire afternoon session on Tuesday, October 23, will be devoted to transradial.
For more information and background on the transradial approach, visit Angioplasty.Org’s Transradial Access Center.
2 Responses to “Annual Report” of Stent Procedures Shows Big Increase in Wrist Angioplasty
Dear Dr. Rao,
I enjoyed reading your inspiring report on significant increase in Transradial Angiography and PCI. I would like to know how many Transradial approach is being performed in USA alone or worldwide .
I look forward to hearing from you.
Farida — Thanks for you kind words. Dr. Rao’s report should be out shortly, and we will be covering it when it does. The NCDR report showed that for the U.S., 8.3% of diagnostic tests and 6.9% of angioplasty and stenting procedures were done transradially from Jan. 1, 2010, through June 30, 2011. As for other countries, it varies widely. France, Japan, China and India do the vast majority of their cases via radial, from what we understand. Stay tuned because we’ll be posting an interview in the near future with Dr. Ferdinand Kiemeneij, the “father” of transradial intervention…and he talks about this issue as well. — The Editor