The benefits of radial access
This summer, JACC published a meta-analysis of 24 studies comparing access approaches in coronary interventions for nearly 23,000 patients. Radial access emerged as the superior option; it was associated with lower risk for all-cause mortality, major adverse cardiovascular events, major bleeding, and major vascular complications.
Additionally, a recent study in JACC: Cardiovascular Interventions examined outcomes and costs among nearly 280,000 patients in the NCDR CathPCI Registry who received a PCI from 2009 to 2012. Across the cohort, radial access was performed in 9% of patients and was associated with lower adjusted costs of $916. The authors estimated that with a 30% shift to both radial access and same-day discharge—which is often enabled by radial access—a hospital performing 1,000 procedures annually could save $1 million, and the country could save $300 million each year.
While the national radial access rate has increased dramatically in the past several years, the United States still lags behind other countries such as Japan and Canada. Radial access has not fully penetrated many CV programs.