Right arm distal transradial (snuffbox) access for coronary catheterization: Initial experience

Area of Science:

• Cardiology
• Vascular Access Techniques
• Interventional Cardiology

Background:

• Distal transradial access (dTRA) in the anatomical snuffbox is an emerging alternative to traditional forearm transradial access (TRA).
• This approach offers potential advantages but also presents unique challenges.
• Evaluating the efficacy and safety of dTRA exclusively from the right arm is crucial for its wider adoption.

Purpose of the Study:

• To assess the effectiveness and safety of performing coronary catheterization using exclusively the right distal transradial access (dTRA) approach.
• To evaluate radial artery patency and complication rates following dTRA.

Main Methods:

• A prospective study involving 49 patients undergoing coronary catheterization at two centers.
• Exclusively utilized right dTRA for all procedures.
• Assessed radial artery patency at the forearm and snuffbox regions via triplex ultrasonography 24 hours post-procedure.
• Monitored all complications for 24 hours.

Main Results:

• The overall failure incidence for dTRA was 10.2%, with a mean puncture time of 3.9 minutes.
• Manual hemostasis was significantly shorter (11 minutes) compared to device hemostasis (198 minutes).
• No instances of distal or forearm radial artery occlusion were observed at 24-hour follow-up; no major complications were reported.

Conclusions:

• This two-center study supports the safety and effectiveness of the right dTRA snuffbox approach in an all-comers population for coronary catheterization.
• The findings contribute valuable data to the growing body of evidence for this technique.
• Further global reports are anticipated to further clarify the nuances of dTRA implementation.