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Comparison of distal transradial approach versus conventional transradial approach for coronary angiography and percutaneous coronary intervention: A prospective observational study
Compared with the conventional transradial approach (TRA), there are limited data on the efficacy and safety of the novel distal transradial approach (DTRA). This study aimed to verify the effectiveness and safety of the DTRA for percutaneous coronary angiography and intervention. Besides, we also t...
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Published in: | Heliyon 2023-06, Vol.9 (6), p.e17150-e17150, Article e17150 |
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description | Compared with the conventional transradial approach (TRA), there are limited data on the efficacy and safety of the novel distal transradial approach (DTRA). This study aimed to verify the effectiveness and safety of the DTRA for percutaneous coronary angiography and intervention. Besides, we also try to highlight the potential of the DTRA in reducing radial artery occlusion (RAO), shorter time to hemostasis, and improved patient comfort.
This single-center prospective observational study enrolled patients treated with DTRA (n = 527) in the first 9 months and with TRA (n = 586) in the next 8 months from May 2020 to December 2021. The primary endpoint was the proximal RAO rate at 30 days.
Baseline data were similar between the two groups. The proximal radial artery occlusion rate at 30 days [2.3% vs. 7.0%], the success rate of puncture [86.4% vs. 96.7%], the Numeric Rating Scale score [1.97 ± 1.89 vs. 4.61 ± 2.68], and the incidence of postoperative subcutaneous hematoma and finger numbness [3.4% vs. 8.2%, 2.7% vs. 4.4%] were lower. The puncture time [6.93 ± 7.25 min vs. 3.18 ± 3.52 min] was longer, and the time until radial compression device removal was shorter [CAG: 138.61 ± 38.73 min vs. 191.6 ± 61.22 min, PCI:221.46 ± 62.45 min vs. 276.28 ± 76.39 min] in the DTRA group than TRA group (all P |
doi_str_mv | 10.1016/j.heliyon.2023.e17150 |
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This single-center prospective observational study enrolled patients treated with DTRA (n = 527) in the first 9 months and with TRA (n = 586) in the next 8 months from May 2020 to December 2021. The primary endpoint was the proximal RAO rate at 30 days.
Baseline data were similar between the two groups. The proximal radial artery occlusion rate at 30 days [2.3% vs. 7.0%], the success rate of puncture [86.4% vs. 96.7%], the Numeric Rating Scale score [1.97 ± 1.89 vs. 4.61 ± 2.68], and the incidence of postoperative subcutaneous hematoma and finger numbness [3.4% vs. 8.2%, 2.7% vs. 4.4%] were lower. The puncture time [6.93 ± 7.25 min vs. 3.18 ± 3.52 min] was longer, and the time until radial compression device removal was shorter [CAG: 138.61 ± 38.73 min vs. 191.6 ± 61.22 min, PCI:221.46 ± 62.45 min vs. 276.28 ± 76.39 min] in the DTRA group than TRA group (all P < 0.05). Multivariate logistic regression analysis revealed that the DTRA (OR 0.231, 95% confidence interval [CI] 0.088–0.769, P = 0.001),BMI<18.5 kg/m2 (OR 2.627, 95% CI 1.142–4.216, P = 0.004), Diabetes mellitus (OR 2.15, 95%CI1.212–3.475, P = 0.014), RCD removal time (CAG,min) (OR 1.091, 95% CI 1.013–1.441, P = 0.035) and RCD removal time (PCI,min) (OR 1.067, 95% CI 1.024–1.675, P = 0.022) were the independent risk factors of RAO 1 month after intervention procedure.
DTRA was found to a lower incidence of postoperative RAO and bleeding-related complications, shorter time to achieve hemostasis, and greater patient comfort.</description><identifier>ISSN: 2405-8440</identifier><identifier>EISSN: 2405-8440</identifier><identifier>DOI: 10.1016/j.heliyon.2023.e17150</identifier><identifier>PMID: 37360091</identifier><language>eng</language><publisher>England: Elsevier Ltd</publisher><subject>Coronary angiography ; Distal radial artery ; Percutaneous coronary intervention ; Radial artery ; Snuffbox area</subject><ispartof>Heliyon, 2023-06, Vol.9 (6), p.e17150-e17150, Article e17150</ispartof><rights>2023 The Authors</rights><rights>2023 The Authors. Published by Elsevier Ltd.</rights><rights>2023 The Authors. Published by Elsevier Ltd. 2023</rights><lds50>peer_reviewed</lds50><oa>free_for_read</oa><woscitedreferencessubscribed>false</woscitedreferencessubscribed><cites>FETCH-LOGICAL-c482t-116fd32983022ab52774585d4b713f1968c5744f62bc40db9e0d4424af7335213</cites><orcidid>0000-0002-3523-0573 ; 0000-0003-3454-5546</orcidid></display><links><openurl>$$Topenurl_article</openurl><openurlfulltext>$$Topenurlfull_article</openurlfulltext><thumbnail>$$Tsyndetics_thumb_exl</thumbnail><linktopdf>$$Uhttps://www.ncbi.nlm.nih.gov/pmc/articles/PMC10285130/pdf/$$EPDF$$P50$$Gpubmedcentral$$Hfree_for_read</linktopdf><linktohtml>$$Uhttps://www.sciencedirect.com/science/article/pii/S240584402304358X$$EHTML$$P50$$Gelsevier$$Hfree_for_read</linktohtml><link.rule.ids>230,314,727,780,784,885,3549,27924,27925,45780,53791,53793</link.rule.ids><backlink>$$Uhttps://www.ncbi.nlm.nih.gov/pubmed/37360091$$D View this record in MEDLINE/PubMed$$Hfree_for_read</backlink></links><search><creatorcontrib>Feng, Chunguang</creatorcontrib><creatorcontrib>Zong, Bin</creatorcontrib><creatorcontrib>Liu, Yi</creatorcontrib><creatorcontrib>Chen, Mei</creatorcontrib><creatorcontrib>Li, Shanshan</creatorcontrib><creatorcontrib>Xu, Dujuan</creatorcontrib><creatorcontrib>Han, Bing</creatorcontrib><title>Comparison of distal transradial approach versus conventional transradial approach for coronary angiography and percutaneous coronary intervention: A prospective observational study</title><title>Heliyon</title><addtitle>Heliyon</addtitle><description>Compared with the conventional transradial approach (TRA), there are limited data on the efficacy and safety of the novel distal transradial approach (DTRA). This study aimed to verify the effectiveness and safety of the DTRA for percutaneous coronary angiography and intervention. Besides, we also try to highlight the potential of the DTRA in reducing radial artery occlusion (RAO), shorter time to hemostasis, and improved patient comfort.
This single-center prospective observational study enrolled patients treated with DTRA (n = 527) in the first 9 months and with TRA (n = 586) in the next 8 months from May 2020 to December 2021. The primary endpoint was the proximal RAO rate at 30 days.
Baseline data were similar between the two groups. The proximal radial artery occlusion rate at 30 days [2.3% vs. 7.0%], the success rate of puncture [86.4% vs. 96.7%], the Numeric Rating Scale score [1.97 ± 1.89 vs. 4.61 ± 2.68], and the incidence of postoperative subcutaneous hematoma and finger numbness [3.4% vs. 8.2%, 2.7% vs. 4.4%] were lower. The puncture time [6.93 ± 7.25 min vs. 3.18 ± 3.52 min] was longer, and the time until radial compression device removal was shorter [CAG: 138.61 ± 38.73 min vs. 191.6 ± 61.22 min, PCI:221.46 ± 62.45 min vs. 276.28 ± 76.39 min] in the DTRA group than TRA group (all P < 0.05). Multivariate logistic regression analysis revealed that the DTRA (OR 0.231, 95% confidence interval [CI] 0.088–0.769, P = 0.001),BMI<18.5 kg/m2 (OR 2.627, 95% CI 1.142–4.216, P = 0.004), Diabetes mellitus (OR 2.15, 95%CI1.212–3.475, P = 0.014), RCD removal time (CAG,min) (OR 1.091, 95% CI 1.013–1.441, P = 0.035) and RCD removal time (PCI,min) (OR 1.067, 95% CI 1.024–1.675, P = 0.022) were the independent risk factors of RAO 1 month after intervention procedure.
DTRA was found to a lower incidence of postoperative RAO and bleeding-related complications, shorter time to achieve hemostasis, and greater patient comfort.</description><subject>Coronary angiography</subject><subject>Distal radial artery</subject><subject>Percutaneous coronary intervention</subject><subject>Radial artery</subject><subject>Snuffbox area</subject><issn>2405-8440</issn><issn>2405-8440</issn><fulltext>true</fulltext><rsrctype>article</rsrctype><creationdate>2023</creationdate><recordtype>article</recordtype><sourceid>DOA</sourceid><recordid>eNqFkstu1DAUhiMEolXpI4CyZDODr3HCBlUjLpUqsYG15djHMx5l7GA7kebB-n54OqG0C8TKRz6_v3PxX1VvMVpjhJsP-_UOBncMfk0QoWvAAnP0orokDPFVyxh6-SS-qK5T2iOEMG-bTtDX1QUVtEGow5fV_SYcRhVdCr4OtjYuZTXUOSqfojKuxGocY1B6V88Q05RqHfwMPrvg_yW0IRZVLIJ4rJXfurCNatydYlOPEPWUlYfwwFpUzmeIC_ZjfVMXUhpBZzdDHfpUcmqpmPJkjm-qV1YNCa6X86r6-eXzj8231d33r7ebm7uVZi3JK4wbayjpWooIUT0nQjDecsN6ganFXdNqLhizDek1Q6bvABnGCFNWUMoJplfV7ZlrgtrLMbpDaVYG5eTDRYhbqWJ2egBJwSjFiECmxUww1FlkieiMwcBV03aF9enMGqf-AEaXYaMankGfZ7zbyW2YJUak5ZiiQni_EGL4NUHK8uCShmE4b1OS05y44w0tUn6W6rLIFME-1sFIniwk93KxkDxZSJ4tVN69e9rk46s_hvk7BZS1zw6iTNqB12BcLP9V9uL-U-I3ZGng_Q</recordid><startdate>20230601</startdate><enddate>20230601</enddate><creator>Feng, Chunguang</creator><creator>Zong, Bin</creator><creator>Liu, Yi</creator><creator>Chen, Mei</creator><creator>Li, Shanshan</creator><creator>Xu, Dujuan</creator><creator>Han, Bing</creator><general>Elsevier Ltd</general><general>Elsevier</general><scope>6I.</scope><scope>AAFTH</scope><scope>NPM</scope><scope>AAYXX</scope><scope>CITATION</scope><scope>7X8</scope><scope>5PM</scope><scope>DOA</scope><orcidid>https://orcid.org/0000-0002-3523-0573</orcidid><orcidid>https://orcid.org/0000-0003-3454-5546</orcidid></search><sort><creationdate>20230601</creationdate><title>Comparison of distal transradial approach versus conventional transradial approach for coronary angiography and percutaneous coronary intervention: A prospective observational study</title><author>Feng, Chunguang ; Zong, Bin ; Liu, Yi ; Chen, Mei ; Li, Shanshan ; Xu, Dujuan ; Han, Bing</author></sort><facets><frbrtype>5</frbrtype><frbrgroupid>cdi_FETCH-LOGICAL-c482t-116fd32983022ab52774585d4b713f1968c5744f62bc40db9e0d4424af7335213</frbrgroupid><rsrctype>articles</rsrctype><prefilter>articles</prefilter><language>eng</language><creationdate>2023</creationdate><topic>Coronary angiography</topic><topic>Distal radial artery</topic><topic>Percutaneous coronary intervention</topic><topic>Radial artery</topic><topic>Snuffbox area</topic><toplevel>peer_reviewed</toplevel><toplevel>online_resources</toplevel><creatorcontrib>Feng, Chunguang</creatorcontrib><creatorcontrib>Zong, Bin</creatorcontrib><creatorcontrib>Liu, Yi</creatorcontrib><creatorcontrib>Chen, Mei</creatorcontrib><creatorcontrib>Li, Shanshan</creatorcontrib><creatorcontrib>Xu, Dujuan</creatorcontrib><creatorcontrib>Han, Bing</creatorcontrib><collection>ScienceDirect Open Access Titles</collection><collection>Elsevier:ScienceDirect:Open Access</collection><collection>PubMed</collection><collection>CrossRef</collection><collection>MEDLINE - Academic</collection><collection>PubMed Central (Full Participant titles)</collection><collection>Directory of Open Access Journals</collection><jtitle>Heliyon</jtitle></facets><delivery><delcategory>Remote Search Resource</delcategory><fulltext>fulltext</fulltext></delivery><addata><au>Feng, Chunguang</au><au>Zong, Bin</au><au>Liu, Yi</au><au>Chen, Mei</au><au>Li, Shanshan</au><au>Xu, Dujuan</au><au>Han, Bing</au><format>journal</format><genre>article</genre><ristype>JOUR</ristype><atitle>Comparison of distal transradial approach versus conventional transradial approach for coronary angiography and percutaneous coronary intervention: A prospective observational study</atitle><jtitle>Heliyon</jtitle><addtitle>Heliyon</addtitle><date>2023-06-01</date><risdate>2023</risdate><volume>9</volume><issue>6</issue><spage>e17150</spage><epage>e17150</epage><pages>e17150-e17150</pages><artnum>e17150</artnum><issn>2405-8440</issn><eissn>2405-8440</eissn><abstract>Compared with the conventional transradial approach (TRA), there are limited data on the efficacy and safety of the novel distal transradial approach (DTRA). This study aimed to verify the effectiveness and safety of the DTRA for percutaneous coronary angiography and intervention. Besides, we also try to highlight the potential of the DTRA in reducing radial artery occlusion (RAO), shorter time to hemostasis, and improved patient comfort.
This single-center prospective observational study enrolled patients treated with DTRA (n = 527) in the first 9 months and with TRA (n = 586) in the next 8 months from May 2020 to December 2021. The primary endpoint was the proximal RAO rate at 30 days.
Baseline data were similar between the two groups. The proximal radial artery occlusion rate at 30 days [2.3% vs. 7.0%], the success rate of puncture [86.4% vs. 96.7%], the Numeric Rating Scale score [1.97 ± 1.89 vs. 4.61 ± 2.68], and the incidence of postoperative subcutaneous hematoma and finger numbness [3.4% vs. 8.2%, 2.7% vs. 4.4%] were lower. The puncture time [6.93 ± 7.25 min vs. 3.18 ± 3.52 min] was longer, and the time until radial compression device removal was shorter [CAG: 138.61 ± 38.73 min vs. 191.6 ± 61.22 min, PCI:221.46 ± 62.45 min vs. 276.28 ± 76.39 min] in the DTRA group than TRA group (all P < 0.05). Multivariate logistic regression analysis revealed that the DTRA (OR 0.231, 95% confidence interval [CI] 0.088–0.769, P = 0.001),BMI<18.5 kg/m2 (OR 2.627, 95% CI 1.142–4.216, P = 0.004), Diabetes mellitus (OR 2.15, 95%CI1.212–3.475, P = 0.014), RCD removal time (CAG,min) (OR 1.091, 95% CI 1.013–1.441, P = 0.035) and RCD removal time (PCI,min) (OR 1.067, 95% CI 1.024–1.675, P = 0.022) were the independent risk factors of RAO 1 month after intervention procedure.
DTRA was found to a lower incidence of postoperative RAO and bleeding-related complications, shorter time to achieve hemostasis, and greater patient comfort.</abstract><cop>England</cop><pub>Elsevier Ltd</pub><pmid>37360091</pmid><doi>10.1016/j.heliyon.2023.e17150</doi><orcidid>https://orcid.org/0000-0002-3523-0573</orcidid><orcidid>https://orcid.org/0000-0003-3454-5546</orcidid><oa>free_for_read</oa></addata></record> |
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subjects | Coronary angiography Distal radial artery Percutaneous coronary intervention Radial artery Snuffbox area |
title | Comparison of distal transradial approach versus conventional transradial approach for coronary angiography and percutaneous coronary intervention: A prospective observational study |
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