Transradial Access: where we are

A popular hashtag among cardiologists on Twitter, #RadialFirst hopes to promote the adoption of transradial access for cardiac catheterization and percutaneous coronary intervention (PCI) in cath labs across the world thanks to a deepening evidence base of positive outcomes.

The evidence shows that transradial access is associated with reductions in bleeding, vascular complications, and time to ambulation compared with a femoral approach. However, while the adoption of the transradial approach is increasing in the United States, the approach is not as widely used as it is in Europe, Canada and Asia—perhaps due to the challenges in the approach’s learning curve.

So, what is the current state of the transradial approach in the United States? That is the question a new comprehensive literature review from the Duke Clinical Research Institute, published in Cardiovascular Innovations and Applications, set out to answer.

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Stents not effective? Study sparks debate pt. 1

U.K. PCI study sparks U.S. debate

On Wednesday, November 1, results from the Objective Randomized Blinded Investigation with Optimal Medical Therapy of Angioplasty in Stable Angina (ORBITA) study were published in The Lancet.

The next day, this article was published in the New York Times:

“A procedure used to relieve chest pain in hundreds of thousands of heart patients each year is useless for many of them,” it began… “The new study, published in the Lancet, stunned leading cardiologists by countering decades of clinical experience. The findings raise questions about whether stents should be used so often—or at all—to treat chest pain.”

Without further knowledge, the debate may start right here—the New York Times article had little in the way of medical detail to satisfy invasive cardiovascular professionals and may have further generalized results in a misleading manner.

But let’s hold off on reacting, look at the debate surrounding this particular study and also place the findings in a wider context (part two). Note: this isn’t the first time it has been suggested that stents are overused.

Continue reading Stents not effective? Study sparks debate pt. 1