Feasibility of distal transradial access for coronary angiography and percutaneous coronary intervention: an observational and prospective study in a Latin-American Centre

• Published in: Acta Cardiologica 2023-01, Vol.78 (1), p.55-63
• Main Authors: Escutia-Cuevas, Héctor Hugo, Alcantara Melendez, Marco, Jiménez-Valverde, Arnoldo Santos, Zaragoza-Rodriguez, Gregorio, Vargas-Cruz, Antonio, Garcia-Garcia, Juan Francisco, Ordonez-Salazar, Bayardo Antonio, Flores-Morgado, Antonio, Orozco Guerra, Guillermo, Renteria-Valencia, Diego Alvaro
• Format: Article
• Language: English
• Subjects: Angiography; angioplasty; Arterial Occlusive Diseases; Coronary Angiography - adverse effects; Coronary Angiography - methods; coronary interventions; dTRA; Feasibility Studies; Humans; percutaneous coronary intervention; Percutaneous Coronary Intervention - adverse effects; Percutaneous Coronary Intervention - methods; Prospective Studies; Radial Artery; transradial; Treatment Outcome
• ISSN: 0001-5385; 1784-973X; 0373-7934
• DOI: 10.1080/00015385.2021.2015546

Distal transradial access (dTRA) as a refinement of the conventional transradial access (TRA) has advantages in terms of risk of radial artery occlusion (RAO). In order to evaluate the real-world feasibility and safety of dTRA as the default access site for routine coronary angiography (CAG) and percutaneous coronary intervention (PCI) in a Latin-American centre, this prospective observational registry was conducted. Consecutive patients with a prior assessment for CAG and/or PCI were enrolled in this single-centre prospective registry from October 2018 to March 2019. The primary endpoints were the success rate of CAG and PCI. Secondary endpoints included the success rate of puncture of the distal radial artery, complications at the puncture site and puncture time. The success rates of CAG and PCI were 100% (155/155) and 97% (69/71), respectively. Puncture time and fluoroscopic time were 52 ± 19 seconds and 16.3 ± 35.4 minutes, respectively. Haemostasis time was 142 ± 45 min. A total of 19 (12.5%) puncture site complications occurred, including 18 (11.6%) minor haematomas and one (0.6%) arterial perforation, in which the artery was patent at the one-month follow-up. Five patients complained of left thumb numbness at a one-month follow-up. No distal radial artery occlusion, pseudoaneurysm, or arteriovenous fistula occurred. The success and complication rates of ldTRA support the feasibility and safety of this procedure using the appropriate materials in previously selected patients.