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Transradial Access (Interventional Radiology)

Modern endovascular access technique: low complication rate and patient comfort

Written by: Saygı Hospital Health Guide Editorial Board
Last updated:

This content has been compiled by the Saygı Hospital Health Guide Editorial Board and is periodically reviewed by a specialist physician.

References (5)

This content is for informational purposes only and does not constitute medical advice. You can book an appointment at our Radyoloji department. Book Appointment →

What is Transradial Access (Interventional Radiology)?

Transradial access is a method initially used in cardiology procedures (PCI, coronary angiography) and increasingly applied to peripheral interventions (visceral, peripheral arterial, cerebral, oncologic embolization). The radial artery diameter is 2.5-3 mm, smaller than the femoral artery (8-10 mm), but suitable for catheters up to 7-8 Fr with the use of slender catheters and ultrasound guidance.

Advantages: reduced bleeding complications (1% transradial vs 5-10% transfemoral), faster mobilization (immediate after procedure), increased patient comfort, shorter hospital stay, and lower cost. Especially valuable in obese, anticoagulated, and peripheral arterial disease patients.

Allen test (or Barbeau test, plethysmography) is required preoperatively to assess ulnar collateral; access site is 1-2 cm proximal to radial styloid using ultrasound guidance, micropuncture with 21-22G needle, then introducer. Radial spasm cocktail (verapamil 2.5 mg + nitroglycerin 200 µg) reduces vasospasm. Radial artery occlusion (RAO) is the most common complication (5-10%); radial compression band hemostasis with 'patent hemostasis' technique reduces RAO.

Symptoms

Indication for endovascular intervention
Preoperative Allen test (ulnar collateral assessment)
Patient comfort priority
Difficult femoral access (obesity, peripheral arterial disease)
Anticoagulated patient (reduced bleeding risk)
Outpatient procedure planning

Risk Factors

Failed Allen/Barbeau test (ulnar circulation insufficient)
Radial artery diameter <2 mm (US measured)
Active radial vasospasm or atherosclerosis
AV fistula or radial graft
Forearm/wrist trauma history
Severe Raynaud's phenomenon

When to See a Doctor?

If you experience any of the following symptoms, seek medical attention promptly:

  • Need for endovascular intervention indication
  • Cardiovascular pre-procedure consultation
  • Vascular access decision
  • Hand pain, numbness or coldness after procedure (RAO suspicion)
  • Bleeding from access site or hematoma
  • Hand color change or movement loss

Treatment Methods

01
Ultrasound-guided micropuncture access (preferred technique)
02
Spasm cocktail administration (verapamil + nitroglycerin)
03
Slender hydrophilic introducer/sheath usage
04
Patent hemostasis technique (TR Band)
05
Postprocedure 2-4 hour pulse oximetry monitoring (RAO surveillance)
06
Heparinization (50-70 IU/kg, 5000 IU minimum)

Which Department to Visit?

You can visit our Radyoloji department for these complaints. Our specialist physicians will create the most suitable treatment plan for you.

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Health Disclaimer: The information on this page is prepared for general informational purposes only. It does not replace medical diagnosis and treatment. Please consult your physician for your complaints. Saygı Hospital does not accept responsibility for actions taken based on the information on this page.