Cochrane corner: is it better to access the coronary circulation via the radial or the femoral artery?


Coronary heart disease is the most common cause of morbidity and mortality worldwide.1 Coronary artery disease (CAD) is a term referring to partial or complete blockage in blood supply to the heart. In a certain subset of patients with CAD, such as those with the acute coronary syndrome (ACS) and symptomatic patients despite optimal medical therapy, revascularisation of the blocked arteries is often indicated.2 Historically, coronary artery bypass grafting (CABG) has been the mainstay of revascularisation therapy. The advent of percutaneous coronary intervention (PCI) since the late 1990s, particularly with the development of drug-eluting stents, has increasingly challenged the role of CABG, with a growing momentum towards less invasive approaches.3 The gold standard for visualising coronary anatomy is diagnostic coronary angiography (CA) with an ultimate goal of intervention on the blocked or stenosed segment to restore blood flow to the ischaemic heart muscle….

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