Distal transradial access for cardiac catheterization: A systematic scoping review

Area of Science:

• Cardiology
• Interventional Cardiology
• Vascular Access

Background:

• Distal transradial access (dTRA), utilizing the anatomical snuffbox, offers potential benefits over conventional transradial access (cTRA).
• These advantages include improved left-sided access for grafts and preservation of the proximal radial artery.
• However, the procedural details and safety of dTRA require further clarification.

Purpose of the Study:

• To systematically review the existing literature on cardiac catheterization and coronary angiography performed via distal transradial access (dTRA).
• To evaluate the procedural success and complication rates associated with dTRA.
• To compare the outcomes of dTRA with conventional transradial access (cTRA).

Main Methods:

• A comprehensive literature search was conducted in Ovid MEDLINE and EMBASE up to September 2018.
• Two independent reviewers performed study selection and data extraction.
• Descriptive statistics were used to summarize data from eligible publications on dTRA in adults undergoing cardiac interventions.

Main Results:

• The review included 19 publications with 4,212 participants undergoing dTRA.
• The overall success rate for dTRA was 95.4%, with major complications occurring in 2.4% of cases.
• Complication rates were similar between dTRA and cTRA, with a low incidence of radial artery occlusion (1.7%).

Conclusions:

• Observational data suggest dTRA is a safe and feasible option for percutaneous cardiac procedures.
• dTRA demonstrates high procedural success and low complication rates.
• Further high-quality randomized controlled trials are needed to directly compare dTRA with cTRA.