Feasibility and Safety of the Distal Transradial Artery for Coronary Diagnostic or Interventional Catheterization

Abstract

Background. This prospective study compared the success rate and safety of a distal transradial artery (dTRA) approach to that of the conventional transradial artery (TRA) for coronary angiography or percutaneous coronary intervention. Methods. From January 2019 to April 2020, nine hundred consecutive patients (height < 190 cm) scheduled for coronary angiography or percutaneous coronary interventions were randomly and equally assigned to receive either dTRA or conventional TRA catheterization. Results. Successful access was achieved in 96.00% and 96.67% of the dTRA and conventional TRA groups, respectively ( P = 0.814 ). Compared with the TRA group, patients in the dTRA experienced significantly less hemostatic band removal time (150.5 ± 50.5 cf. 210.6 ± 60.5 min, P = 0.032 ); minor bleeding of the access site (2.44% cf. 6.44%, P = 0.038 ); hemostatic band cost (USD; 0.1 cf. 59.4, P = 0 ); and postprocedural radial artery occlusion (1.56% cf. 3.78%, P = 0.035 ). A lower body mass index was a higher risk factor for dTRA access failure (odds ratio = 0.79, P = 0.024 ), with a cutoff of 22.04 kg/m2. Conclusion. Compared to conventional TRA, dTRA had a comparable high success rate, with fewer associated complications. Clinicians should use the dTRA with caution in patients with low body mass index.

Distal Transradial Access in Anatomical Snuffbox for Coronary Angiography and Intervention: An Updated Meta-Analysis

“…The meta-analysis showed compared with cTRA, the hemostatic device removal time was shorter in dTRA, with the statistical difference between studies (WMD = −66.62 min, 95CI [−76.68, −56.56], P < 0.001; I 2 = 55.7%, P =0.105) (see Figure 10 ). We conducted a sensitivity analysis by removing the outlier study, heterogeneity was significantly reduced after excluding the study by Lin [ 18 ], and there was still a statistical difference (WMD = −72.83 min, 95CI [−82.39, −63.27], P < 0.001; I 2 = 0.0%, P =0.656). The Egger test showed no publication bias among the studies ( P =0.588).…”

“…Note: weights are from random effects analysis Overall (I 2 = 78.5%, p = 0.000) Overall (I 2 = 0.0%, p = 0.733) We conducted a sensitivity analysis by removing the outlier study, heterogeneity was significantly reduced after excluding the study by Lin [18], and there was still a statistical difference (WMD � −72.83 min, 95CI [−82.39, −63.27], P < 0.001; I 2 � 0.0%, P � 0.656). e Egger test showed no publication bias among the studies (P � 0.588).…”

Safety and Effectiveness of Coronary Angiography or Intervention through the Distal Radial Access: A Meta-Analysis

“…en, the full-texts of the remaining 11 studies were reviewed, and 5 additional studies were excluded. Finally, 6 studies [8,[12][13][14][15][16] were included in this meta-analysis. e processes of screening are shown in Figure 1.…”

Distal Radial Artery Access in comparison to Forearm Radial Artery Access for Cardiac Catheterization: A Randomized Controlled Trial (DARFORA Trial)

“…Exclusions from eligibility were implemented to guarantee the safety of STEMI patients and hemodynamically unstable individuals. However, with more operator expertise, these situations may be safely operated by DRA [ 11 , 12 ]. Furthermore, patients whose access is restricted to the left or right side, radial AVF for hemodialysis and CABG, were omitted to assure randomization.…”

“…is new technique has several advantages over FRA, including a lower risk of local complications, notably radial artery occlusion, and enhanced patient and operator comfort [9][10][11][12][13].…”