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Thread: Cardiovascular Angioplasty: Radial access vs. Femoral access

  1. #1
    Junior Member
    Join Date
    Nov 2009

    Cardiovascular Angioplasty: Radial access vs. Femoral access

    I am a nursing student in an RN-BSN program and currently work on a telemetry unit where I care for a lot of patients who are post cardiovascular angioplasty procedure. So far, all of my patients who have had an angioplasty procedure are accessed through the femoral artery. I know that the radial artery may be used as an access site as well, but I have never seen one performed. There are benefits to using a radial artery: it sits close to the skin, easier to detect and stop post-angioplasty bleeding, and get up and walk faster. I read a report from Harvard Health in which a Canadian study had been performed on people who had radial artery angioplasty. Their results proved that the patients who had radial artery angioplasty less often (1.4%) needed a blood transfusion than patients who had femoral artery angioplasty (2.8%). Also, deaths in the year that followed the procedure were lower from 2.8% in the radial artery group and 3.9% in the femoral artery group.

    My question that I would like to ask: For patients undergoing angioplasty, is radial access as effective as femoral access? What have you seen through your practice? Have you seen any studies that prove otherwise?

    I would appreciate your response.

    Thank you,
    Marisol Paz

  2. #2

    Thumbs up

    Yes, I have seen radial artery approach many times. Our docs are warming up to it and we like the results. The benefits are the patient can sit up right away, bedrest time is practically nil, and outpatients can be discharged in a few hours if no intervention is done. It is much safer for obese patients. We have seen some pretty bad complications on obese patients using the femoral artery. If you make sure the allens test is ok, the risks are far less. We even use a special device to hold pressure on the radial artery that is a modified zip tie. The downside is it is more difficult for the doc to perform. The procedure is also usually longer for a radial approach. But overall, I heartily endorse it, especially for obese patients.

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