Radial artery access in women undergoing percutaneous coronary procedures.

SEE PAGE 505 C omplications of vascular access are common after diagnostic coronary angiography and percutaneous coronary intervention (PCI), and include bleeding from the arterial access site, hematoma and pseudoaneurysm formation, and retroperitoneal hemorrhage (1). These complications are uncomfortable, often extend hospital stay, and can result in potentially dangerous interruption of antiplatelet medications, transfusion of blood products, and subsequent peripheral vascular procedures that carry their own inherent risks. As a result, patients who experience bleeding following PCI have an increased risk of death, with hazard ratios for death increasing from 1.7 to 4.9 with increasing severity of bleeding (2). Identifying ways to decrease vascular complication rates and bleeding in patients undergoing coronary angiography and PCI is, therefore, important. There is a paucity of data regarding clinical outcomes of women undergoing PCI (3), but it is known that, compared with men, women are at a particularly high risk of access site complications following PCI (1,3–5). Previous studies suggest that the use of radial access for PCI reduces bleeding risk in both men and women (5,6). Radial artery access, however, is technically more challenging in women because of smaller caliber radial arteries and increased rate of radial artery spasm (7), resulting in frequent procedure failure