Distal Radial Access: A Review Article

Liontou, Catherine; Kontopodis, Eleftherios; Oikonomidis, Nikolaos; Maniotis, Christos; Tassopoulos, Andreas; Tsiafoutis, Ioannis; Lazaris, Efstathios; Koutouzis, Michael

doi:10.1016/j.carrev.2019.06.003

Cited by 26 publications

(32 citation statements)

References 23 publications

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“…Data on the use of the dRA approach for endovascular procedures are currently still limited in the interventional cardiology and neurointerventional literature,12 but available studies suggest that dRA access has additional advantages over the standard transradial access such as decreased rates of dRA occlusion and theoretically fewer ischemic events,7–10 significantly shorter post-procedural duration of hemostasis as well as slightly higher patient satisfaction 23. Although critical hand ischemia after transradial access is infrequent, the dRA approach may offer a theoretical advantage of reduced risk for ischemic hand complications as the origin of the superficial palmar branch lies proximal to the anatomical snuffbox access site and antegrade blood flow remains preserved in the event of a dRA injury or occlusion 24 25…”

Section: Discussionmentioning

confidence: 99%

Distal radial access in the anatomical snuffbox for neurointerventions: a feasibility, safety, and proof-of-concept study

Kühn

Rodrigues

Singh

et al. 2020

J NeuroIntervent Surg

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PurposeTo report the first use of distal radial artery (dRA) access for a variety of neurointerventions and to demonstrate the safety and feasibility of this approach.MethodsA retrospective review of our prospective neurointerventional database of endovascular interventions was conducted and, between May and October 2019, all patients in whom the intervention was performed via dRA in the anatomical snuffbox were identified. Patient demographics, clinical information, procedural and radiographic data were collected.Results48 patients with a mean age of 64.4 years (range 35–84 years) were included. 27 patients were female. dRA access was achieved in all cases. Conversion to femoral access was required in five cases (10.4%) due to tortuous vessel anatomy and limited support of the catheters in the aortic arch. Interventions performed included aneurysm treatment (with flow diverters, Woven EndoBridge device placement, coiling or stent-assisted coiling), arteriovenous malformation and dural arteriovenous fistula embolization, carotid artery stentings, stroke thrombectomy, thrombolysis for central retinal artery occlusion, intracranial stenting, middle meningeal artery embolization, vasospasm treatment, and spinal angiography with embolization. Radial artery vasospasm was seen in two cases and successfully treated with antispasmolytic medication. No symptomatic radial artery occlusion or ischemic event was observed.ConclusiondRA access is safe and effective for a variety of neurointerventions. Our preliminary experience with this approach is very promising and shows high patient satisfaction.

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Section: Discussionmentioning

confidence: 99%

Distal radial access in the anatomical snuffbox for neurointerventions: a feasibility, safety, and proof-of-concept study

Kühn

Rodrigues

Singh

et al. 2020

J NeuroIntervent Surg

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“…In recent years, the distal transradial approach (dTRA), as an alternative approach for cardiac catheterization, has gradually become familiar to cardiologic interventionalists. In the past 2 years, an increasing number of studies have focused on the feasibility and safety of the dTRA approach for coronary angiography (CAG) and percutaneous coronary intervention (PCI) in different countries [7][8][9][10][11][12][13][14][15]. However, as a new approach, it also has some disadvantages.…”

Section: Introductionmentioning

confidence: 99%

Distal transradial access: a review of the feasibility and safety in cardiovascular angiography and intervention

Cai

Huang

Feng

et al. 2020

BMC Cardiovasc Disord

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Background: Transradial access (TRA) has been considered as the default choice in cardiac catheterization. Although infrequent, vascular complications of this approach remain. Recently, the distal transradial approach (dTRA) in cardiac catheterization was reported by interventionalists. Methods: We retrieved the relevant literatures and reviewed the safety and feasibility of this novel approach in cardiac catheterization. Results: The dTRA for cardiac intervention has superior safety and satisfaction. As a novel approach for cardiac catheterization, access related complications should also be considered by operators, such as RAO, radial spasm, bleeding and haematoma, and injury of the superficial branch of the radial nerve. Conclusions: The dTRA in cardiovascular angiography and intervention was safe and feasible.

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“…These results are comparable to data from other registries. In a review article on 1118 patients, the observed cannulation success rate was between 88 and 100% [ 21 ]. In our opinion, the problems that were encountered in our registry would have forced a crossover after pTRA in the same patients.…”

Section: Discussionmentioning

confidence: 99%

“…In 2017 an innovative YouTube © Video by one of the inventors of TRA, Dr. Kiemeneij ( https://www.youtube.com/watch?v=-If5oAF0KJo ) and the use of social media (Twitter©) helped to spread the dRA around the globe and sparked several authors to explore this new puncture site [ 16 , 19 , 21 , 23 , 29 , 37 ]. One of the main clinical advantages of dRA that was consistently reported in these articles was a very low rate of RAO.…”

Section: Introductionmentioning

confidence: 99%

Distal Transradial Access for Coronary Angiography and Interventions in Everyday Practice: Data From the TRIANGLE Registry (TwitteR Initiated registry for coronary ANgiography in Germany via distaL radial accEss)

Schenke

Viertel

Joghetaei³

et al. 2021

Cardiol Ther

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Introduction: Transradial access (TRA) has become the primary route for coronary angiography (CAG) and percutaneous coronary interventions (PCI). Recently a new puncture site more distally in the area of the anatomical snuffbox has been described. With this multicenter registry, we wish to demonstrate the feasibility and safety of the distal radial access (dRA).Methods: Between December 2018 and May 2019 all patients with a planned CAG or PCI via dRA in three cardiology centers in Germany were entered into this registry. Procedural data, puncture success, crossover rate and complications were registered. Proximal and distal radial artery patency were examined by ultrasound within 48 h. Results: A total of 327 patients were enrolled (mean age: 69 ± 12 years, 69% male gender, 49% PCI), in 5 cases bilateral distal puncture was performed. Puncture success, defined as completed sheath placement was high (N = 316/332, 95%) and the crossover rate was low (27/332, 8%). The rate of proximal radial artery occlusion after 1-48 h was low (2/332 1%), the rate of occlusion at the distal puncture site was also very low (3/332, 1%). Major complications were not encountered. Conclusion: Coronary angiography and interventions via the distal transradial access in the area of the anatomical snuffbox can be performed with a high rate of success and safety. This data suggests a reduced rate of radial artery occlusion compared to previously reported data after cannulation via the standard forearm radial artery puncture site. Randomized studies are needed to further investigate these results. Trial Registration: This study was registered in the German registry for clinical trials: DRKS00017110, retrospectively on 07.May 2019

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Distal Radial Access: A Review Article

Cited by 26 publications

References 23 publications

Distal radial access in the anatomical snuffbox for neurointerventions: a feasibility, safety, and proof-of-concept study

Distal radial access in the anatomical snuffbox for neurointerventions: a feasibility, safety, and proof-of-concept study

Distal transradial access: a review of the feasibility and safety in cardiovascular angiography and intervention

Distal Transradial Access for Coronary Angiography and Interventions in Everyday Practice: Data From the TRIANGLE Registry (TwitteR Initiated registry for coronary ANgiography in Germany via distaL radial accEss)

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