AUTHOR=Eltelbany Moemen , Fabbri Matteo , Batchelor Wayne B. , Cilia Lindsey , Ducoffe Aaron , Endicott Kendall , Epps Kelly , McBurnie Amika , Neville Richard , Rosner Carolyn , Sherwood Matthew W. , Spinosa David , Truesdell Alexander G. , Vorgang Cassandra , Damluji Abdulla A. , Tehrani Behnam N. TITLE=Best practices for vascular arterial access and closure: a contemporary guide for the cardiac catheterization laboratory JOURNAL=Frontiers in Cardiovascular Medicine VOLUME=11 YEAR=2024 URL=https://www.frontiersin.org/journals/cardiovascular-medicine/articles/10.3389/fcvm.2024.1349480 DOI=10.3389/fcvm.2024.1349480 ISSN=2297-055X ABSTRACT=
More than 1 million transcatheter-based cardiovascular procedures across the spectrum of interventional cardiology are performed annually in the United States. With the expanded indications for and increased complexities associated with these procedures, interventional cardiologists are expected to possess the requisite expertise to complete these interventions safely and effectively. While the art of vascular access and closure remains a prerequisite and critical skillset in contemporary practice, there remain significant variations in the techniques employed, resulting in the bleeding and vascular complications encountered in clinical practice. With an increasing recognition of the potential merits to standardized approaches to vascular access and closure, cardiovascular societies have put forth recommendations around best practices for performing these procedures in the cardiac catheterization laboratories. In this review, we aim to: (1) Examine the evolving definitions of bleeding and vascular complications; (2) Review best practices for transradial and transfemoral access and closure, including for large bore procedures; and (3) Highlight knowledge gaps and proposed areas of clinical research pertaining to vascular access which may inform clinical practice and potentially optimize the outcomes of patients undergoing transcatheter-based cardiac and vascular interventions.