Preventing Radial Artery Occlusion by Using Reverse Barbeau Assessment: Bringing Evidence-Based Practice to the Bedside

The traditional approach to percutaneous coronary angiography and intervention (PCI) is by femoral artery access. However, in recent years, a paradigm shift has occurred in catheterization laboratories across the nation: transradial PCI. In 2007, only 1.3% of all PCIs done in the United States used the transradial approach. This percentage has now increased to more than 20%.¹  This dramatic increase is chiefly due to higher patient satisfaction rates, reduced bed rest and recovery times, and a 78% lower risk for bleeding and vascular complications with transradial procedures than for the femoral approach.² 

In 2008, the director of Women’s Heart Health, an interventional cardiologist, brought transradial PCI to our facility to offer patients, especially female patients, a safer PCI option. With femoral access, women have a higher risk of PCI bleeding complications than men have (2.86% vs 1.22%, P < .01).³  Transradial access reduces this risk to 1.1%...