Do you recommend avoiding radial artery access for cardiac catheterization to preserve potential future dialysis access sites in patients with advanced CKD?  

With Radial arterial catheterization ( RA-CA), structural damage to the artery manifests as intimal tears and medial dissection along the length of the vessel. Further, even though 2-30% of the arteries will thrombose, about 50% of these will recanalize at 1 month. In spite of this, endothelial func...

A major reason for primary failure and inadequate maturation of forearm radio-cephalic arteriovenous fistulas is poor arterial blood flow. Transradial cardiac catheterization can lead to radial artery occlusion (1-12%) and non-occlusive radial artery stenosis in 31% of patients based on Doppler ultr...

Generally speaking at our center, we continue to use the radial artery access as a default for Cardiac procedures. We don’t think that these interventions affect the future creation of AV access. Further, most of these patients end up having upper arm fistulas or forearm AV grafts in general ...

Most of our CKD patients don't get Cimino fistulas because of vascular disease and the majority have upper arm AVFs. Therefore, we don't usually interfere with cardiologists' choices regarding arterial access for angiograms.

I think it is a good idea. I am not aware of the advantages of radial artery access versus femoral artery access but for years only femoral artery access was performed for cardiac caths. Thus, I believe femoral artery access even though may be less ideal but still very safe and there is tons of expe...

The data published (Latif et al., PMID 34389155) shows an important advantage to radial access in this subset of patients with reduced mortality and bleeding compared to femoral approaches. Emotional responses based on theoretical concerns is not supported in real-world practice. Renal patients ofte...

I utilize distal (snuffbox) radial access for these patients. This approach theoretically leads to less proximal/forearm radial occlusion. This has been demonstrated in a number of studies. Radial artery access is safer and should not be avoided due to the concern related to future dialysis access. ...