You could learn more about cardiology courses with Prof. Sameh Allam by clicking on the courses’ library link here:

Objectives for this course:
1- Master the essentials of a successful complex PCI by using the radial approach
2- Essential questions on radial approach and the use of the specific radial device(s)
3- Clinical case strategy and radial approach limits
4- Anatomical variations in the Radial artery.
5- Master the essential steps of a successful radial procedure.

In this lecture we will discuss more about transradial artery access (TRA) for percutaneous coronary intervention (PCI) and how is associated with lower bleeding and vascular complications than transfemoral artery access (TFA), especially in patients with acute coronary syndromes (ACS).
Use of TRA for coronary angiography and PCI may also be associated with improved measures of quality of life and reduced costs compared with TFA.


Acute coronary syndrome continues to be a significant cause of morbidity and mortality in the United States. Family physicians need to identify and mitigate risk factors early, as well as recognize and respond to acute coronary syndrome events quickly in any clinical setting. Diagnosis can be made based on patient history, symptoms, electrocardiography findings, and cardiac biomarkers, which delineate between ST elevation myocardial infarction and non–ST elevation acute coronary syndrome. Rapid reperfusion with primary percutaneous coronary intervention is the goal with either clinical presentation. Coupled with appropriate medical management, percutaneous coronary intervention can improve short- and long-term outcomes following myocardial infarction. If percutaneous coronary intervention cannot be performed rapidly, patients with ST elevation myocardial infarction can be treated with fibrinolytic therapy. Fibrinolysis is not recommended in patients with non–ST elevation acute coronary syndrome; therefore, these patients should be treated with medical management if they are at low risk of coronary events or if percutaneous coronary intervention cannot be performed. Post–myocardial infarction care should be closely coordinated with the patient's cardiologist and based on a comprehensive secondary prevention strategy to prevent recurrence, morbidity, and mortality.

TRA should be considered the default strategy in the invasive management of patients with ACS. In the ACS population, TRA is associated with a significantly lower incidence of bleeding and vascular complications and potentially mortality compared with TFA. The mortality benefit is clearly observed in high-risk ACS (eg, STEMI, cardiogenic shock) and in patients with high predicted bleeding risk. The use of TRA in these patients requires operator and institutional experience to optimize procedural outcomes. Compared with TFA, TRA is also associated with improved quality of life, reduced healthcare resource use, and reduced healthcare costs. For these reasons and to facilitate adequate procedural expertise for high-risk patient subgroups, TRA should be considered the preferred access site strategy.

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