Operators who like us began adopting the radial approach were impressed by the many benefits the procedure offers for their daily work and in particular appreciated the gratifying comments of patients who found they were able to walk around the ward within a few hours of undergoing coronary angioplasty.
It was mainly for this reason that we decided to launch the Radiale project, transformed into Club Radiale in 2010, and have devoted constant efforts to providing information on the procedure throughout Italy based on the experience of operators who are already using the technique.
Scientific Director and Editor in Chief
A short history of the radial approach
1989–First report in the literature (Campeu et al) of the use of the radial artery as an access route for cardiac catheterization. The approach was immediately seen to offer considerable advantages in terms of safety and early ambulation and was gradually adopted by numerous European centres.
1992–Kiemeneij in Amsterdam began using radial access to perform percutaneous coronary angioplasty and stenting.
1994–Fajadet performed a transradial coronary angioplasty procedure live during TCT in Washington, prompting growing interest in the method.
Pros
Numerous studies have demonstrated that radial access gives a high success rate (>90%) in suitably selected patients. The frequency of traditional vascular complications (haematoma, pseudoaneurism and fistulae) is very low and major haemorrhagic complications close to 0% (no reports in the literature). Clinical experience has shown that early ambulation following the procedure is not only highly appreciated amongst patients themselves but also allows for the possibility of early discharge strategies, bringing potential benefits in terms of healthcare costs.
Cons
It took about ten years for radial access to become accepted by the international community and even today the technique accounts for fewer than 20% of all catheterization procedures. This reluctance on the part of cath lab operators to adopt the technique is largely due to its longer learning curve compared to the traditional femoral approach, the need to use smaller guide catheters, and the manual skill required in the use of catheters. Rather than a technical challenge, operators tend to view these three factors merely as a waste of time and energy.