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April 6, 2009 -- 10:00pm EDT

Cardiology Sites Taking Notice of the Radial Approach to Angioplasty and Stenting (PCI)
Two months ago, I wrote about a poll on theheart.org, which asked the question: "Should radial access become the default choice for PCI?" Well, as of today, the poll is still on their home page. Evidently radial access is a popular enough topic to warrant two whole months of display.

This is interesting on several levels: one, this poll has been posted and open for voting on theheart.org considerably longer than previous polls; two, as of this morning (see graphic above) over 500 votes have been tallied from healthcare professionals who read theheart.org (this is a lot of votes for a typical poll on their site!); and three, the vote is 50/50! -- and has been so over the past couple of months, sometimes going up to 52/48 in favor of radial.

This last point, the vote results, is even more interesting because the most recent data from the NCDR database shows that less than 3% of angioplasties done in the U.S. are done via the radial artery in the wrist; the mainstay of catheter-based procedures in this country remains the femoral artery in the leg/groin. (Not so around the world, where 50% or greater is the norm. In fact those cardiologists who are proficient with the radial technique tend to use it in 70-80% of their cases.)

So if less than 3% of PCIs are done via the wrist, why is the vote 50/50? Is it because many cardiologists from outside the U.S. have been voting? Or is it because many cardiologists feel that radial should be the preferred access site -- but they just don't practice it themselves? Or, more likely, aren't trained in it?

For two years now, Angioplasty.Org has been offering a special section on this technique, our Transradial Access Center, offering information to both physicians and patients about the advantages of the radial approach: less complications, greater patient comfort, cost-effectiveness, etc. And we've also been listing training opportunities, U.S. hospital centers where radial is practiced, interviews with key cardiologists who use it. And we've seen increasing interest in the radial approach as a result.

In fact, today the weekly poll on another "professionals only" cardiology site, CRTonline.org, asks the question:

"How frequently should radial access for PCI be used? Greater than 50%, between 20-50% or less than 20%."

Only 64 votes have been cast at present, and almost half are saying "less than 20%", so it will be "interesting" to see how this goes as the week progresses.

So...to you radialists out there, go vote!!

Late Update: Alas! theheart.org has taken down its poll -- glad I got a screenshot of the final tally.

Later Update: The poll at theheart.org -- is back online!

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