Objective: The research aimed for examining the safety and effectiveness of distal trans-radial access (dTRA), a new coronary intervention procedure, in individuals with low BMI. Methods: The design of this study was a cross sectional study design. This study was conducted at Mayo Hospital Lahore and the duration of this study was from December 2020 to December 2022. The participants of this study was 67 patients who had a coronary intervention. The patients were divided into two groups: 38 patients had traditional trans-radial access (cTRA) and 29 patients got direct trans-radial access (dTRA). Results: The research outcomes indicated that the success rates for puncture procedures in both groups, dTRA and cTRA, were not significantly different. Specifically, the success rate for dTRA was found to be 96.6% while cTRA recorded a success rate of 97.4%. This difference was not considered to be statistically significant as the p-value was 0.846, which means there was an 84.6% chance that the results were due to random chance and not a true difference between the groups. This indicates that both dTRA and cTRA are effective in puncture procedures and can produce similar results in terms of success rate. It is crucial to consider these results alongside the limitations of the research. Despite the overall results indicating a similar success rate between the two groups, there was a disparity in success rates for single-needle puncture procedures. In this aspect, the cTRA group outperformed the dTRA group with a success rate of 81.6% compared to 51.7% for the dTRA group. This difference was statistically significant with a p-value of 0.020, indicating that the results were not due to random chance. However, the dTRA group did have some advantages over the cTRA group. The compression hemostasis time, the time required for the bleeding to stop, was faster for the dTRA group, with a p-value of 0.01. Additionally, the incidence of radial artery occlusion was less frequent in the dTRA group compared to the cTRA group, with a p-value of 0.007 (4% compared to 33.3% in the cTRA group). Practical Implication: The study examines the first-time use of dTRA in low BMI people and looks at efficacy and safety. With a success rate of 96.6% in the dTRA group and a success rate of 97.4% in the control group (cTRA), the puncture success rate was found to be comparable between the two groups. The success rate was lower in the dTRA group compared to the cTRA group, and it took them longer to penetrate the skin with a single needle. The two groups' puncture-related side effects, such as bleeding and hematoma, were not significantly different from one another. Even though the dTRA group's patients reported more comfort, the dTRA group's compression hemostasis time and Visual Analog Scale (VAS) ratings were lower. Conclusion: The research shows that in individuals with low BMI, coronary intervention with dTRA is both secure and efficient. This approach offers a less complicated, more effective, and efficient alternative to conventional trans-radial access. Keywords: Conventional Trans-Radial Access, Body Mass Index, Percutaneous Coronary Intervention, Bleeding, Puncture

Introduction: Acute kidney injury (AKI) is a common complication that can occur after invasive cardiac procedures. This condition can cause significant morbidity and mortality, especially in high-risk patients, such as those with preexisting renal dysfunction. Objectives: The main objective of the study is to find the association of radial artery access with reduced incidence of acute kidney injury. Material and methods: The study is conducted at the Department of Cardiology, Hayatabad Medical Complex, Peshawar. This is a tertiary care center that provides cardiac care services to a large population of the Khyber Pakhtunkhwa province of Pakistan. The center has state-of-the-art facilities and a team of experienced cardiologists and cardiac surgeons who perform a variety of cardiac procedures, including PCI and CABG. Results: Based on a study of 300 patients undergoing cardiac catheterization, there was a significant association between the use of radial artery access and reduced incidence of acute kidney injury (AKI). The study found that 20% of patients who underwent femoral artery access developed AKI, compared to only 10% of patients who underwent radial artery access. This indicates that radial artery access may be a safer option for cardiac catheterization procedures, as it may help reduce the risk of AKI in patients. Conclusion: In conclusion, the present study provides evidence that radial artery access is associated with a lower incidence of acute kidney injury (AKI) in patients undergoing percutaneous coronary intervention (PCI).

Background: Regardless of the recent rise in the number of articles published on transradial access (TRA) for diagnostic coronary intervention and complications of the upper extremity may be underestimated. The aim of this study to investigate the prevalence of upper extremity disorder by comparing the transradial and transfemoral artery percutaneous coronary intervention (TR-PCI). Study Design: This was cross-sectional study and conducted in the Ayub teaching hospital Abbotabad, for six months July 2022 to December 2022. Materials and Methods: The total participants were 250 which included 200 TRA and 50 TFA participants and involving any type of cerdiointervention, thrombectomies for acute ischemic stroke, and carotid artery stents. The participants were selected by sampling technique were interviewed in the Khyber teaching hospital Peshawar. We analyzed dependent and independent variables. Data analysis statistically by SPSS 22 version. The upper extremity scores were analyzed using Chi-squared test. Results: There were total 250 participants which include 80%TRA and 20% TFA in this research. The majority of the participants in TRA were in the age group (59.2±6.7) years and in TFA group (55.5±7.1) years. The baseline characteristics of the total participants was no significant difference between transradial artery (TRA) and transradial femoral artery (TFA). During follow-up, Cochran's Q-test revealed a significant increase in UED in the intervention extremity of the TRA group p=0.003 and in the TFA group's right upper extremity (p=0.001). During follow-up, 1% TRA participants had RAO, which recanalized over time. Three weeks after the procedure, 10% of participants in the TRA group were referred to a hand specialist then TFA participants. Conclusion: Transradial arterial access (TRA) for percutaneous coronary artery intervention has been linked to lower access site complication rates and higher patient satisfaction when compared to transfemoral access (TFA) after 3 weeks follow up. Keywords: Transradial artery (TRA), Transfemoral artery (TFA), Rotational acetabular osteotomy (RAO).