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Comparison of the feasibility and safety between distal transradial access and conventional transradial access in patients with acute chest pain: a single-center cohort study using propensity score matching
Distal transradial access (dTRA) has been suggested to have great advantages over cTRA. However, there is a lack of preliminary data on dTRA in patients undergoing emergency coronary angiography (CAG) or percutaneous coronary intervention (PCI). To explore the feasibility and safety of distal transr...
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| Published in: | BMC geriatrics 2023-06, Vol.23 (1), p.348-348, Article 348 |
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| creator | Li, Wenhua Wang, Juan Liang, Xiaofang Wang, Qiang Chen, Tao Song, Yanbin Shi, Ganwei Li, Feng Li, Yong Xiao, Jianqiang Cai, Gaojun |
| description | Distal transradial access (dTRA) has been suggested to have great advantages over cTRA. However, there is a lack of preliminary data on dTRA in patients undergoing emergency coronary angiography (CAG) or percutaneous coronary intervention (PCI). To explore the feasibility and safety of distal transradial access in patients with acute chest pain.
A total of 1269 patients complaining of acute chest pain in our emergency department from January 2020 to February 2022 were retrospectively included. The patients who met the inclusion criteria were divided into the conventional transradial access (cTRA) group (n = 238) and the dTRA group (n = 158). Propensity score matching was used to minimize the baseline differences.
The cannulation success rate in the dTRA group was significantly lower than that in the cTRA group (87.41% vs. 94.81%, p 0.05). Compared with the cTRA group, the hemostasis duration was significantly shorter [4(4, 4) h vs. 10(8, 10) h, p |
| doi_str_mv | 10.1186/s12877-023-04058-y |
| format | article |
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A total of 1269 patients complaining of acute chest pain in our emergency department from January 2020 to February 2022 were retrospectively included. The patients who met the inclusion criteria were divided into the conventional transradial access (cTRA) group (n = 238) and the dTRA group (n = 158). Propensity score matching was used to minimize the baseline differences.
The cannulation success rate in the dTRA group was significantly lower than that in the cTRA group (87.41% vs. 94.81%, p < 0.05). No significant differences in the puncture time and total procedure time were noted between the two groups (p > 0.05). Compared with the cTRA group, the hemostasis duration was significantly shorter [4(4, 4) h vs. 10(8, 10) h, p < 0.001) and the incidence of minor bleeding (BARC Type I and II) was significantly lower in the dTRA group than that in the cTRA group (0.85% vs. 5.48%, p = 0.045). Asymptomatic radial artery occlusion was observed in six patients (5.83%) in the cTRA group and one patient (1.14%) in the dTRA group (p = 0.126). The subgroup analysis of ST-elevation myocardial infarction (STEMI) showed no significant differences in the puncture time, D-to-B time or total procedure time between the two groups.
The dTRA for emergency CAG or PCI has an acceptable success rate and puncture time, a shorter hemostasis time, and a downward trend in RAO rate compared to the cTRA. The dTRA did not increase the D-to-B time in emergency coronary interventions in STEMI patients. On the contrary, a low incidence of RAO by the dTRA created an opportunity for future coronary interventions in non-culprit vessels in the same access.
Retrospectively registered in Chinese Clinical Trial Registry (registry number: ChiCTR2200061104, date of registration: June 15, 2022).</description><identifier>ISSN: 1471-2318</identifier><identifier>EISSN: 1471-2318</identifier><identifier>DOI: 10.1186/s12877-023-04058-y</identifier><identifier>PMID: 37270473</identifier><language>eng</language><publisher>England: BioMed Central Ltd</publisher><subject>Acute chest pain ; Acute coronary syndromes ; Aged patients ; Angiography ; Body mass index ; Care and treatment ; Chest ; Chest pain ; Chest Pain - diagnostic imaging ; Chest Pain - epidemiology ; Cholesterol ; Cohort analysis ; Cohort Studies ; Coronary vessels ; Distal transradial access ; Electrocardiography ; Emergency medical care ; Emergency procedure ; Feasibility Studies ; Fistula ; Geriatrics ; Hematoma ; Hemostasis ; High density lipoprotein ; Humans ; Ischemia ; Local anesthesia ; Myocardial infarction ; Older people ; Pain ; Patient outcomes ; Patients ; Percutaneous Coronary Intervention - adverse effects ; Percutaneous Coronary Intervention - methods ; Propensity Score ; Radial Artery - diagnostic imaging ; Radial Artery - surgery ; Radial artery occlusion ; ST Elevation Myocardial Infarction ; Treatment Outcome ; Trinucleotide repeats ; Veins & arteries</subject><ispartof>BMC geriatrics, 2023-06, Vol.23 (1), p.348-348, Article 348</ispartof><rights>2023. The Author(s).</rights><rights>COPYRIGHT 2023 BioMed Central Ltd.</rights><rights>2023. This work is licensed under http://creativecommons.org/licenses/by/4.0/ (the “License”). Notwithstanding the ProQuest Terms and Conditions, you may use this content in accordance with the terms of the License.</rights><rights>The Author(s) 2023</rights><lds50>peer_reviewed</lds50><oa>free_for_read</oa><woscitedreferencessubscribed>false</woscitedreferencessubscribed><citedby>FETCH-LOGICAL-c564t-f9a4a96793c1399add97da76bf0949362d6fc9ce93d5ce988d0b4767d37e9b133</citedby><cites>FETCH-LOGICAL-c564t-f9a4a96793c1399add97da76bf0949362d6fc9ce93d5ce988d0b4767d37e9b133</cites></display><links><openurl>$$Topenurl_article</openurl><openurlfulltext>$$Topenurlfull_article</openurlfulltext><thumbnail>$$Tsyndetics_thumb_exl</thumbnail><linktopdf>$$Uhttps://www.ncbi.nlm.nih.gov/pmc/articles/PMC10238772/pdf/$$EPDF$$P50$$Gpubmedcentral$$Hfree_for_read</linktopdf><linktohtml>$$Uhttps://www.proquest.com/docview/2827027958?pq-origsite=primo$$EHTML$$P50$$Gproquest$$Hfree_for_read</linktohtml><link.rule.ids>230,314,727,780,784,885,25751,27922,27923,37010,37011,38514,43893,44588,53789,53791</link.rule.ids><backlink>$$Uhttps://www.ncbi.nlm.nih.gov/pubmed/37270473$$D View this record in MEDLINE/PubMed$$Hfree_for_read</backlink></links><search><creatorcontrib>Li, Wenhua</creatorcontrib><creatorcontrib>Wang, Juan</creatorcontrib><creatorcontrib>Liang, Xiaofang</creatorcontrib><creatorcontrib>Wang, Qiang</creatorcontrib><creatorcontrib>Chen, Tao</creatorcontrib><creatorcontrib>Song, Yanbin</creatorcontrib><creatorcontrib>Shi, Ganwei</creatorcontrib><creatorcontrib>Li, Feng</creatorcontrib><creatorcontrib>Li, Yong</creatorcontrib><creatorcontrib>Xiao, Jianqiang</creatorcontrib><creatorcontrib>Cai, Gaojun</creatorcontrib><title>Comparison of the feasibility and safety between distal transradial access and conventional transradial access in patients with acute chest pain: a single-center cohort study using propensity score matching</title><title>BMC geriatrics</title><addtitle>BMC Geriatr</addtitle><description>Distal transradial access (dTRA) has been suggested to have great advantages over cTRA. However, there is a lack of preliminary data on dTRA in patients undergoing emergency coronary angiography (CAG) or percutaneous coronary intervention (PCI). To explore the feasibility and safety of distal transradial access in patients with acute chest pain.
A total of 1269 patients complaining of acute chest pain in our emergency department from January 2020 to February 2022 were retrospectively included. The patients who met the inclusion criteria were divided into the conventional transradial access (cTRA) group (n = 238) and the dTRA group (n = 158). Propensity score matching was used to minimize the baseline differences.
The cannulation success rate in the dTRA group was significantly lower than that in the cTRA group (87.41% vs. 94.81%, p < 0.05). No significant differences in the puncture time and total procedure time were noted between the two groups (p > 0.05). Compared with the cTRA group, the hemostasis duration was significantly shorter [4(4, 4) h vs. 10(8, 10) h, p < 0.001) and the incidence of minor bleeding (BARC Type I and II) was significantly lower in the dTRA group than that in the cTRA group (0.85% vs. 5.48%, p = 0.045). Asymptomatic radial artery occlusion was observed in six patients (5.83%) in the cTRA group and one patient (1.14%) in the dTRA group (p = 0.126). The subgroup analysis of ST-elevation myocardial infarction (STEMI) showed no significant differences in the puncture time, D-to-B time or total procedure time between the two groups.
The dTRA for emergency CAG or PCI has an acceptable success rate and puncture time, a shorter hemostasis time, and a downward trend in RAO rate compared to the cTRA. The dTRA did not increase the D-to-B time in emergency coronary interventions in STEMI patients. On the contrary, a low incidence of RAO by the dTRA created an opportunity for future coronary interventions in non-culprit vessels in the same access.
Retrospectively registered in Chinese Clinical Trial Registry (registry number: ChiCTR2200061104, date of registration: June 15, 2022).</description><subject>Acute chest pain</subject><subject>Acute coronary syndromes</subject><subject>Aged patients</subject><subject>Angiography</subject><subject>Body mass index</subject><subject>Care and treatment</subject><subject>Chest</subject><subject>Chest pain</subject><subject>Chest Pain - diagnostic imaging</subject><subject>Chest Pain - epidemiology</subject><subject>Cholesterol</subject><subject>Cohort analysis</subject><subject>Cohort Studies</subject><subject>Coronary vessels</subject><subject>Distal transradial access</subject><subject>Electrocardiography</subject><subject>Emergency medical care</subject><subject>Emergency procedure</subject><subject>Feasibility Studies</subject><subject>Fistula</subject><subject>Geriatrics</subject><subject>Hematoma</subject><subject>Hemostasis</subject><subject>High density lipoprotein</subject><subject>Humans</subject><subject>Ischemia</subject><subject>Local anesthesia</subject><subject>Myocardial infarction</subject><subject>Older people</subject><subject>Pain</subject><subject>Patient outcomes</subject><subject>Patients</subject><subject>Percutaneous Coronary Intervention - adverse effects</subject><subject>Percutaneous Coronary Intervention - methods</subject><subject>Propensity Score</subject><subject>Radial Artery - diagnostic imaging</subject><subject>Radial Artery - surgery</subject><subject>Radial artery occlusion</subject><subject>ST Elevation Myocardial Infarction</subject><subject>Treatment Outcome</subject><subject>Trinucleotide repeats</subject><subject>Veins & arteries</subject><issn>1471-2318</issn><issn>1471-2318</issn><fulltext>true</fulltext><rsrctype>article</rsrctype><creationdate>2023</creationdate><recordtype>article</recordtype><sourceid>COVID</sourceid><sourceid>PIMPY</sourceid><sourceid>DOA</sourceid><recordid>eNptks9u1DAQxiMEoqXwAhyQJS5cUmI7iWMuqKr4U6kSFzhbjj3ZeJXYi-202pfsMzG7W0oXVZGS0cxvPmfGX1G8pdU5pV37MVHWCVFWjJdVXTVduX1WnNJa0JJx2j1_FJ8Ur1JaVxUVHWtfFidcMFHVgp8Wd5dh3ujoUvAkDCSPQAbQyfVucnlLtLck6QEw7CHfAnhiXcp6Ijlqn6K2DmNtDKS0h03wN-CzC_5pxnmy0dkhksityyPmlwzEjJAyVpz_RDRJzq8mKA1SEFFyDDGTlBe7JcuuRjYxbMCn3R8mEyKQWWczYuV18WLQU4I399-z4tfXLz8vv5fXP75dXV5cl6Zp61wOUtdatkJyQ7mU2loprBZtP1Sylrxlth2MNCC5bfDddbbqa9EKywXInnJ-VlwddG3Qa7WJbtZxq4J2ap8IcaV0zM5MoIw1PTWdNZ3BlUuJsg0XvK0oYyD6HrU-H7Q2Sz-D3U0d9XQkelzxblSrcKMo3jwagKHCh3uFGH4vuEk1u2RgmrSHsCTFOsY4TttJRN__h67DEvGy9pSomJBN949aaZzA-SHgwWYnqi5EQ1vZ0KZF6vwJCh8Ls0MjwOAwf9TADg0mhpQiDA9D0krtLK0OllY4mNpbWm2x6d3j9Ty0_PUw_wNXqfdf</recordid><startdate>20230603</startdate><enddate>20230603</enddate><creator>Li, Wenhua</creator><creator>Wang, Juan</creator><creator>Liang, Xiaofang</creator><creator>Wang, Qiang</creator><creator>Chen, Tao</creator><creator>Song, Yanbin</creator><creator>Shi, Ganwei</creator><creator>Li, Feng</creator><creator>Li, Yong</creator><creator>Xiao, Jianqiang</creator><creator>Cai, Gaojun</creator><general>BioMed Central Ltd</general><general>BioMed Central</general><general>BMC</general><scope>CGR</scope><scope>CUY</scope><scope>CVF</scope><scope>ECM</scope><scope>EIF</scope><scope>NPM</scope><scope>AAYXX</scope><scope>CITATION</scope><scope>3V.</scope><scope>7QP</scope><scope>7TK</scope><scope>7X7</scope><scope>7XB</scope><scope>88E</scope><scope>8FI</scope><scope>8FJ</scope><scope>8FK</scope><scope>ABUWG</scope><scope>AFKRA</scope><scope>AZQEC</scope><scope>BENPR</scope><scope>CCPQU</scope><scope>COVID</scope><scope>DWQXO</scope><scope>FYUFA</scope><scope>GHDGH</scope><scope>K9.</scope><scope>M0S</scope><scope>M1P</scope><scope>PIMPY</scope><scope>PQEST</scope><scope>PQQKQ</scope><scope>PQUKI</scope><scope>PRINS</scope><scope>7X8</scope><scope>5PM</scope><scope>DOA</scope></search><sort><creationdate>20230603</creationdate><title>Comparison of the feasibility and safety between distal transradial access and conventional transradial access in patients with acute chest pain: a single-center cohort study using propensity score matching</title><author>Li, Wenhua ; Wang, Juan ; Liang, Xiaofang ; Wang, Qiang ; Chen, Tao ; Song, Yanbin ; Shi, Ganwei ; Li, Feng ; Li, Yong ; Xiao, Jianqiang ; Cai, Gaojun</author></sort><facets><frbrtype>5</frbrtype><frbrgroupid>cdi_FETCH-LOGICAL-c564t-f9a4a96793c1399add97da76bf0949362d6fc9ce93d5ce988d0b4767d37e9b133</frbrgroupid><rsrctype>articles</rsrctype><prefilter>articles</prefilter><language>eng</language><creationdate>2023</creationdate><topic>Acute chest pain</topic><topic>Acute coronary syndromes</topic><topic>Aged patients</topic><topic>Angiography</topic><topic>Body mass index</topic><topic>Care and treatment</topic><topic>Chest</topic><topic>Chest pain</topic><topic>Chest Pain - diagnostic imaging</topic><topic>Chest Pain - epidemiology</topic><topic>Cholesterol</topic><topic>Cohort analysis</topic><topic>Cohort Studies</topic><topic>Coronary vessels</topic><topic>Distal transradial access</topic><topic>Electrocardiography</topic><topic>Emergency medical care</topic><topic>Emergency procedure</topic><topic>Feasibility Studies</topic><topic>Fistula</topic><topic>Geriatrics</topic><topic>Hematoma</topic><topic>Hemostasis</topic><topic>High density lipoprotein</topic><topic>Humans</topic><topic>Ischemia</topic><topic>Local anesthesia</topic><topic>Myocardial infarction</topic><topic>Older people</topic><topic>Pain</topic><topic>Patient outcomes</topic><topic>Patients</topic><topic>Percutaneous Coronary Intervention - adverse effects</topic><topic>Percutaneous Coronary Intervention - methods</topic><topic>Propensity Score</topic><topic>Radial Artery - diagnostic imaging</topic><topic>Radial Artery - surgery</topic><topic>Radial artery occlusion</topic><topic>ST Elevation Myocardial Infarction</topic><topic>Treatment Outcome</topic><topic>Trinucleotide repeats</topic><topic>Veins & arteries</topic><toplevel>peer_reviewed</toplevel><toplevel>online_resources</toplevel><creatorcontrib>Li, Wenhua</creatorcontrib><creatorcontrib>Wang, Juan</creatorcontrib><creatorcontrib>Liang, Xiaofang</creatorcontrib><creatorcontrib>Wang, Qiang</creatorcontrib><creatorcontrib>Chen, Tao</creatorcontrib><creatorcontrib>Song, Yanbin</creatorcontrib><creatorcontrib>Shi, Ganwei</creatorcontrib><creatorcontrib>Li, Feng</creatorcontrib><creatorcontrib>Li, Yong</creatorcontrib><creatorcontrib>Xiao, Jianqiang</creatorcontrib><creatorcontrib>Cai, Gaojun</creatorcontrib><collection>Medline</collection><collection>MEDLINE</collection><collection>MEDLINE (Ovid)</collection><collection>MEDLINE</collection><collection>MEDLINE</collection><collection>PubMed</collection><collection>CrossRef</collection><collection>ProQuest Central (Corporate)</collection><collection>Calcium & Calcified Tissue Abstracts</collection><collection>Neurosciences Abstracts</collection><collection>Health Medical collection</collection><collection>ProQuest Central (purchase pre-March 2016)</collection><collection>Medical Database (Alumni Edition)</collection><collection>Hospital Premium Collection</collection><collection>Hospital Premium Collection (Alumni Edition)</collection><collection>ProQuest Central (Alumni) (purchase pre-March 2016)</collection><collection>ProQuest Central (Alumni)</collection><collection>ProQuest Central</collection><collection>ProQuest Central Essentials</collection><collection>AUTh Library subscriptions: ProQuest Central</collection><collection>ProQuest One Community College</collection><collection>Coronavirus Research Database</collection><collection>ProQuest Central</collection><collection>Health Research Premium Collection</collection><collection>Health Research Premium Collection (Alumni)</collection><collection>ProQuest Health & Medical Complete (Alumni)</collection><collection>Health & Medical Collection (Alumni Edition)</collection><collection>Medical Database</collection><collection>Publicly Available Content Database</collection><collection>ProQuest One Academic Eastern Edition (DO NOT USE)</collection><collection>ProQuest One Academic</collection><collection>ProQuest One Academic UKI Edition</collection><collection>ProQuest Central China</collection><collection>MEDLINE - Academic</collection><collection>PubMed Central (Full Participant titles)</collection><collection>DOAJ Directory of Open Access Journals</collection><jtitle>BMC geriatrics</jtitle></facets><delivery><delcategory>Remote Search Resource</delcategory><fulltext>fulltext</fulltext></delivery><addata><au>Li, Wenhua</au><au>Wang, Juan</au><au>Liang, Xiaofang</au><au>Wang, Qiang</au><au>Chen, Tao</au><au>Song, Yanbin</au><au>Shi, Ganwei</au><au>Li, Feng</au><au>Li, Yong</au><au>Xiao, Jianqiang</au><au>Cai, Gaojun</au><format>journal</format><genre>article</genre><ristype>JOUR</ristype><atitle>Comparison of the feasibility and safety between distal transradial access and conventional transradial access in patients with acute chest pain: a single-center cohort study using propensity score matching</atitle><jtitle>BMC geriatrics</jtitle><addtitle>BMC Geriatr</addtitle><date>2023-06-03</date><risdate>2023</risdate><volume>23</volume><issue>1</issue><spage>348</spage><epage>348</epage><pages>348-348</pages><artnum>348</artnum><issn>1471-2318</issn><eissn>1471-2318</eissn><abstract>Distal transradial access (dTRA) has been suggested to have great advantages over cTRA. However, there is a lack of preliminary data on dTRA in patients undergoing emergency coronary angiography (CAG) or percutaneous coronary intervention (PCI). To explore the feasibility and safety of distal transradial access in patients with acute chest pain.
A total of 1269 patients complaining of acute chest pain in our emergency department from January 2020 to February 2022 were retrospectively included. The patients who met the inclusion criteria were divided into the conventional transradial access (cTRA) group (n = 238) and the dTRA group (n = 158). Propensity score matching was used to minimize the baseline differences.
The cannulation success rate in the dTRA group was significantly lower than that in the cTRA group (87.41% vs. 94.81%, p < 0.05). No significant differences in the puncture time and total procedure time were noted between the two groups (p > 0.05). Compared with the cTRA group, the hemostasis duration was significantly shorter [4(4, 4) h vs. 10(8, 10) h, p < 0.001) and the incidence of minor bleeding (BARC Type I and II) was significantly lower in the dTRA group than that in the cTRA group (0.85% vs. 5.48%, p = 0.045). Asymptomatic radial artery occlusion was observed in six patients (5.83%) in the cTRA group and one patient (1.14%) in the dTRA group (p = 0.126). The subgroup analysis of ST-elevation myocardial infarction (STEMI) showed no significant differences in the puncture time, D-to-B time or total procedure time between the two groups.
The dTRA for emergency CAG or PCI has an acceptable success rate and puncture time, a shorter hemostasis time, and a downward trend in RAO rate compared to the cTRA. The dTRA did not increase the D-to-B time in emergency coronary interventions in STEMI patients. On the contrary, a low incidence of RAO by the dTRA created an opportunity for future coronary interventions in non-culprit vessels in the same access.
Retrospectively registered in Chinese Clinical Trial Registry (registry number: ChiCTR2200061104, date of registration: June 15, 2022).</abstract><cop>England</cop><pub>BioMed Central Ltd</pub><pmid>37270473</pmid><doi>10.1186/s12877-023-04058-y</doi><tpages>1</tpages><oa>free_for_read</oa></addata></record> |
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| ispartof | BMC geriatrics, 2023-06, Vol.23 (1), p.348-348, Article 348 |
| issn | 1471-2318 1471-2318 |
| language | eng |
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| source | Open Access: PubMed Central; Publicly Available Content Database; Coronavirus Research Database |
| subjects | Acute chest pain Acute coronary syndromes Aged patients Angiography Body mass index Care and treatment Chest Chest pain Chest Pain - diagnostic imaging Chest Pain - epidemiology Cholesterol Cohort analysis Cohort Studies Coronary vessels Distal transradial access Electrocardiography Emergency medical care Emergency procedure Feasibility Studies Fistula Geriatrics Hematoma Hemostasis High density lipoprotein Humans Ischemia Local anesthesia Myocardial infarction Older people Pain Patient outcomes Patients Percutaneous Coronary Intervention - adverse effects Percutaneous Coronary Intervention - methods Propensity Score Radial Artery - diagnostic imaging Radial Artery - surgery Radial artery occlusion ST Elevation Myocardial Infarction Treatment Outcome Trinucleotide repeats Veins & arteries |
| title | Comparison of the feasibility and safety between distal transradial access and conventional transradial access in patients with acute chest pain: a single-center cohort study using propensity score matching |
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