Distal Versus Proximal Radial Intervention; Is It Really Worth of It?
Çetin Sarıkamış1
, Kadriye Memiç Sancar1, Ali Birand1, Tuğba Aktemur1, Ali Rıza Demir1, İffet Doğan2, Ömer Aydıner3, İbrahim Faruk Aktürk1
1Department of Cardiology, University of Health Sciences, Mehmet Akif Ersoy Thoracic and Cardiovascular Surgery Training and Research Hospital, İstanbul, Türkiye
2Department of Radiology, University of Health Sciences, Mehmet Akif Ersoy Thoracic and Cardiovascular Surgery Training and Research Hospital, İstanbul, Türkiye
3Department of Radiology, Kartal Lütfi Kırdar Training and Research Hospital, İstanbul, Türkiye
Keywords: Distal radial access; proximal transradial access; radial artery occlusion.
Abstract
Objectives: Distal transradial approach (dTRA) is a promising technique with a decreased risk of radial artery occlusion and puncture-related injuries. There has been no data which compare dTRA and proximal transradial approach (pTRA) in Turkish population group, so far. Thus, researchers aimed to compare the efficacy and safety of the dTRA versus the conventional pTRA in coronary procedures in this study.
Methods: Between September 2021 and June 2022, patients scheduled for transradial angiography at a tertiary cardiac center were enrolled in this study. Patients were randomly selected to undergo coronary imaging using either the distal dTRA or the conventional pTRA in equal numbers. A total of 79 patients were randomized to the proximal approach, and 77 patients were randomized to the dTRA. The primary endpoint was defined as procedural failure.
Results: The success rate of cannulation of the dTRA was significantly lower compared to proximal pTRA (pTRA [89.6%] and pTRA [79%] p=0.002). The rate of radial artery thrombotic complications was not different between groups (proxymal %10.6 vs. distal %5.8, p=0.288). The time of cannulation and total procedural time were longer in the dTRA group (20–40 min, median 25 min) compared to the proximal radial group (15–30 min, median 20 min) p = 0.005. However, this did not affect the total scope time duration 3.3 min. (1.6–6.4) versus 2.4 min (1.6–3.7).
Conclusion: dTRA has a relatively long access time with no advantages in terms of thrombotic complications in the radial artery.
Cite This Article: Sarıkamış Ç, Memiç Sancar K, Birand A, Aktemur T, Demir AR, Doğan İ, et al. Distal Versus Proximal Radial Intervention; Is It Really Worth of It? Koşuyolu Heart J 2024;27(1):22–26.
The study was approved by the University of Health Sciences Mehmet Akif Ersoy Thoracic and Cardiovascular Surgery Training and Research Hospital Clinical Research Ethics Committee (no: 2023.06-63, date: 22/08/2023).
Externally peer-reviewed.
Concept – İ.F.A., Ç.S.; Design –İ.F.A., Ç.S., K.M.S.; Supervision – İ.F.A., Ç.S.; Funding – İ.D., A.R.D.; Materials – Ç.S., A.R.D., A.B.; Data collection and/or processing – Ö.A., A.R.D., İ.D.; Data analysis and/ or interpretation – İ.F.A., Ç.S.; Literature search – T.A., İ.F.A.; Writing – İ.F.A., K.M.S., A.B.; Critical review – İ.F.A., Ç.S., K.M.S.
All authors declared no conflict of interest.
Not declared.
The authors declared that this study received no financial support.
We wish to thank Cardiology Department employes who helped us with data entry.