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TOPLINE:

The use of the radial arterial access site for percutaneous coronary intervention (PCI) in the US increased markedly between 2013 and 2022 and was linked to lower risks for in-hospital mortality, major bleeding, and other vascular complications at the access site but a slightly higher risk for ischemic stroke than the use of the femoral arterial access site.

METHODOLOGY:

• Researchers conducted a retrospective cohort study using data from a US registry to evaluate updated trends in the use of the radial arterial access site for PCI and compare its safety with that of the femoral access site.
• More than 6.65 million PCIs performed between January 2013 and June 2022 were analyzed for temporal trends, of which 2.2 million (median age of the population, 66 years; 31.8% women) were evaluated to compare outcomes of the radial access site with that of the femoral access site.
• The outcomes included in-hospital mortality, major bleeding or other vascular complications at the access site, and ischemic stroke.

TAKEAWAY:

• During the study period, 40.4% of PCIs were performed via the radial access site, with a 2.8-fold increase in the use of this site for PCI from 2013 to 2022 (P for trend < .001); the greatest relative increase was noted in patients who underwent primary PCI for ST-elevation myocardial infarction.
• Radial access site was associated with lower risks for in-hospital mortality (-0.15%), major bleeding at the access site (-0.64%), and other vascular complications at the access site (-0.21%; P < .001 for all) than the femoral access site.
• However, the risk for ischemic stroke was slightly higher with the radial access site than with the femoral arterial access site (absolute risk difference, 0.05%; P < .001).

IN PRACTICE:

The findings “confirm that the benefits of radial access site for PCI that were observed in randomized clinical trials have translated to clinical improvements in outcomes in contemporary, real-world practice,” the researchers reported.

SOURCE:

This study was led by Reza Fazel, MD, of Beth Israel Deaconess Medical Center in Boston. It was published online on July 4, 2025, in the European Heart Journal.

LIMITATIONS:

Procedures involving crossover from one access site to another were not included in the primary analysis. This study may not represent all US hospitals. Follow-up data beyond discharge from the hospital were not available to assess long-term outcomes.

DISCLOSURES:

This study received funding from the National Cardiovascular Data Registry. Several authors reported receiving investigator-initiated research grants from and consulting for various pharmaceutical, medical technology, and healthcare companies. One author reported receiving grants from the National Heart, Blood, and Lung Institute; the FDA; and the Society for Cardiovascular Angiography and Intervention.

This article was created using several editorial tools, including AI, as part of the process. Human editors reviewed this content before publication.