Radial Artery Access for Acute Coronary Syndromes: a Review of Current Evidence

Christopher Kovach, Subhash Banerjee, Stephen Waldo

Research output: Contribution to journalReview articlepeer-review


Purpose of Review: To review the evidence supporting the use of transradial access (TRA) for percutaneous coronary intervention (PCI) in acute coronary syndromes (ACS). Recent Findings: There have been five major randomized controlled trials (RCTs) and two recent meta-analyses comparing outcomes of TRA and femoral access (FA) in ACS. Additional studies have explored the impact of TRA on STEMI door-to-balloon (D2B) times, TRA in high-risk ACS patients, the potential conflict between TRA and coronary artery bypass graft (CABG) surgery employing the radial artery, and distal radial artery (DRA) access. Summary: TRA is associated with a reduction in net adverse clinical events, major bleeding, acute renal injury, and access site complications compared to FA in ACS patients undergoing PCI. TRA is not associated with significant delays in STEMI D2B times that impact patient outcomes. Further studies are needed to evaluate the role of TRA in high-risk ACS patients, the interplay between TRA and radial artery CABG, and use of DRA in ACS.

Original languageEnglish (US)
Pages (from-to)383-392
Number of pages10
JournalCurrent Cardiology Reports
Issue number4
StatePublished - Apr 2022


  • Acute coronary syndrome
  • Femoral artery
  • Mortality
  • Outcomes
  • Radial artery
  • Review
  • ST-elevation myocardial infarction
  • Transradial access

ASJC Scopus subject areas

  • Cardiology and Cardiovascular Medicine


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