Chapter 13: Ideal Vascular Access Introducer Sheath for Transradial Procedures

Transradial coronary artery access has been employed for diagnostic and interventional procedures since it was first described by Campeau in 1989 and its improvement described by Kiemeneij and Laarman in 1993. Improvement in the technique and the equipment has led to the use of the radial approach for diagnostic and interventional procedures in varied coronary syndromes. The radial approach has become increasingly popular and the preferred access site due to lower vascular complication rates, better clinical outcomes, reduced procedural costs, high procedural success, early patient mobilization, and reduced hospitalization when compared to the femoral approach. Transradial intervention was found to be safe and feasible in a large spectrum of clinical practice.

The radial approach is not without complications. Radial artery spasm (RAS) is one of the most common complications of the technique, causing significant discomfort to the patient and reducing the procedural success rate.

Author: 
Sudhir Rathore, MD, MRCP (UK), MD (Res), FESC, FACC