SCAI Statement Defines Best Practices for Transradial Procedures

October 23, 2013—The Society for Cardiovascular Angiography and Interventions (SCAI) announced the publication of a consensus statement by Sunil V. Rao, MD, et al from SCAI's transradial working group that defines best practices for transradial angiography and intervention. The consensus statement is available online ahead of print in SCAI's journal, Catheterization and Cardiovascular Interventions.

Dr. Rao, who is Associate Professor of Medicine at Duke University, commented in SCAI's announcement, “While there are a number of benefits to transradial over transfemoral approaches, there are risks associated with any procedure. By emphasizing proper training and highlighting best practices, we aim to ensure that patients receive the advantages of this approach while minimizing any potential complications.”

SCAI President Ted A. Bass, MD, added, “These best practices are the latest example of our ongoing efforts to provide timely, useful resources to physicians as they care for patients. Our commitment to quality is consistent, as is our belief that we can always do more to improve patient care.”

According to SCAI, between 2007 and 2011, the use of the transradial approach for catheter-based procedures increased nearly tenfold in the United States. As its popularity continues to increase, so does the need for best practices that equip physicians and institutions with tools and information to guide patient care. Studies show a decreased risk for bleeding and vascular complications, increased patient satisfaction, and reduced costs when the transradial approach is used, the society noted.

SCAI advised that the document's recommendations aim to ensure high-quality patient care as transradial access becomes the preferred technique for catheter-based procedures. The statement focuses on three core areas:

1. Best practices for avoiding blocked blood flow to the radial artery. Patients should be assessed before discharge and at the first postprocedure visit to avoid the potential for radial artery occlusion. Extra care also should be taken to ensure patients receive all relevant strategies for prevention of radial artery occlusion.

2. Best practices for reducing potential radiation exposure to patient and operators. To reduce the risk of exposure to radiation during a transradial procedure, the patient's accessed arm should be placed next to his or her torso, additional extension tubing should be used, and operators should be cognizant of safe radiation protocols.

3. Best practices for physicians transitioning to the transradial approach when treating heart attack. Studies have shown benefits when patients experiencing a heart attack undergo angioplasty via the wrist. Steps must be taken to ensure physicians have mastered the technique before performing emergency cases routinely from the wrist. This learning process includes understanding when to revert to access through the femoral artery and how to ensure that using the radial approach does not result in delayed treatment or increased door-to-balloon time.