Nurse-led distal radial access: efficacy, learning curve, and perspectives of an increasingly popular access. Does learning by doing apply to both the doctor and the nurse?

Cereda, Alberto; ALLIEVI, Luca; BUSETTI, Lorenzo; KOLECI, Rita; NORA, Vincenzo DE; VECCHIA, Augustin; Toselli, Marco; Giannini, Francesco; TUMMINELLO, Gabriele; Sangiorgi, Giuseppe

doi:10.23736/s2724-5683.22.05843-4

Cited by 2 publications

(1 citation statement)

References 23 publications

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“…Moreover, the feasibility of the DTRA for patients with CAD, including STsegment-elevation acute coronary syndrome myocardial infarction (STE-ACS), has also replicated fewer complications [16][17][18]. There is still inertia with respect to the adoption of this novel technique, despite its benefits, due to the paucity of data concerning the learning curve, such as the number of cases required to achieve a high proficiency level; however, in some countries, all aspects of DTRA are performed by nursing personnel [15,[19][20]. DRA in the anatomical snuff box has appeared as a possible successor to further reduce the incidence of RAO due to anastomotic perfusion within the hand [7,21].…”

Section: Discussionmentioning

confidence: 99%

Effectiveness and Safety of Left Distal Transradial Access in Coronary Procedures in the Caribbean

Seecheran,

Leyva Quert,

Seecheran

et al. 2024

Cureus

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Introduction: This retrospective study investigated the effectiveness and safety of left distal transradial access (LDTRA) in patients with cardiovascular disease in Trinidad undergoing coronary angiography (CAG) or percutaneous coronary intervention (PCI). Method: Procedural parameters, including technical success and safety outcomes such as vascular complications and radial artery occlusion (RAO), were assessed in 111 consecutive patients undergoing CAG or PCI from January 2023 to June 2023 at the Eric Williams Medical Sciences Complex, Trinidad and Tobago. Eighty-eight patients underwent LDTRA, while 23 received left transradial access (LTRA). Results: There was no difference in procedural success with LDTRA compared to LTRA, 90.9% vs. 100%, p -value 0.202, non-significant (ns). LDTRA was associated with shorter fluoroscopy times (8.4 ± 6.8 minutes vs. 12.4 ± 7.7 minutes, p -value = 0.02), procedural duration (26.7 ± 18 minutes vs. 35.8 ± 20 minutes, p -value = 0.04), and hemostasis time (142 ± 41 minutes vs. 186 ± 44 minutes, p -value < 0.05). There were no significant differences in procedural-related complications (8% for LDTRA vs. 4.3% for LTRA, p -value = 0.476, ns). There were no reported cases of RAO. In the subgroup of patients with prior coronary artery bypass grafting (CABG), the fluoroscopy and procedure times were similar for both access sites; however, LDTRA was associated with a shorter hemostasis time (128 ± 30 minutes vs. 194 ± 39 minutes, p -value = 0.01). Conclusions: LDTRA is effective and safe for coronary procedures and is associated with a shorter hemostasis time. This study may prove clinically pertinent in a limited-resource Caribbean setting.

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Section: Discussionmentioning

confidence: 99%

Effectiveness and Safety of Left Distal Transradial Access in Coronary Procedures in the Caribbean

Seecheran,

Leyva Quert,

Seecheran

et al. 2024

Cureus

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Overview of the distal radial access from the radial artery occlusion perspective

Korotkikh,

Kashtanov

2024

J Vasc Access

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Conventional radial access in endovascular surgery has certain limitations, primarily associated with the presence of local complications and radial artery occlusion. Over the past 7 years, distal radial access has exploded into all areas of endovascular procedures, from interventional cardiology to vascular surgery and interventional oncology. However, puncture of the distal radial artery has its own nuances and features: a learning curve, the use of ultrasound navigation in the initial stages of mastering the access, limitations in patients with acute conditions (acute coronary syndrome and stroke). This review aims to analyze on important aspects of the procedure of distal radial access from preparation for it to hemostasis and to explore all data about the new roles of distal radial access in avoiding but also treating radial artery occlusion, as the first thing to begin with the development and implementation of new access.

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Nurse-led distal radial access: efficacy, learning curve, and perspectives of an increasingly popular access. Does learning by doing apply to both the doctor and the nurse?

Cited by 2 publications

References 23 publications

Effectiveness and Safety of Left Distal Transradial Access in Coronary Procedures in the Caribbean

Effectiveness and Safety of Left Distal Transradial Access in Coronary Procedures in the Caribbean

Overview of the distal radial access from the radial artery occlusion perspective

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