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Feasibility and Safety of Distal Radial Artery Access in Anatomical Snuffbox for Coronary Angiography and Coronary
Arun Maskey1, Birat Krishna Timalsena2, Sheikh Aslam1
1Department of Cardiology, Shahid Gangalal National Heart Center, Bansbari, Kathmandu, Nepal.
Insights
Coronary angiography and interventions using the anatomical snuffbox distal radial artery access are safe and feasible. This transradial approach proved successful in all patients, with minimal complications and no radial artery occlusion.
Area of Science:
- Cardiology
- Vascular Access Procedures
- Interventional Cardiology
Background:
- Limited data exists on radial artery anatomical snuffbox access in South Asia.
- Evaluating feasibility and safety of this approach for coronary procedures is crucial.
Purpose of the Study:
- To assess the feasibility and safety of transradial access at the anatomical snuffbox for coronary angiography and percutaneous coronary intervention.
Main Methods:
- 128 patients underwent attempted transradial access at the anatomical snuffbox for coronary procedures.
- Success rates, procedure completion, and complications were documented.
- Radial artery patency was assessed post-procedure.
Main Results:
- Successful access and sheath placement in all 128 patients.
- Procedures completed in 98.4% of patients (90 angiographies, 36 interventions).
- Low complication rates: 1.5% brachial artery spasm, 2.3% pain/swelling; no bleeding or occlusion.
Conclusions:
- Distal radial artery anatomical snuffbox access is a safe and feasible alternative.
- This approach offers a viable option for coronary angiography and PCI.
Background:
There is limited data on feasibility and safety of coronary interventions performed using radial artery at anatomical snuffbox as vascular access point in South Asian region. Our study attempts to evaluate the feasibility and safety of coronary angiography and percutaneous coronary intervention using transradial access at anatomical snuffbox.
Methods:
Transradial access at anatomical snuffbox was attempted in 128 consecutive patients, who were planned for coronary angiography and/or percutaneous coronary intervention. Success in vascular access, completion of planned procedure and complications encountered, including patency of radial artery after the procedure, were investigated.
Results:
A total of 128 patients (76 males [59.4%]; 52 females [40.6%]) between 44-78 years of age (mean age, 59.0 +/- 10.2 years) were included in the study. Distal radial artery puncture and sheath placement was successful in all patients however planned procedure was completed in 126 (98.4%) patients. Total 90 coronary angiographies and 36 percutaneous coronary interventions were performed of which five were primary percutaneous coronary intervention. We encountered brachial artery spasm among two patient (1.5%) and significant pain and swelling among three patients (2.3%). No bleeding complication, numbness or parasthesia were observed on follow-up. Patients had average pain rating of 2.4+/- 1.1 in visual analogue pain rating scale. There were no instances of radial artery occlusion after the procedure.
Conclusions:
Distal radial artery, at anatomical snuffbox, is a safe and feasible alternative vascular access site for coronary angiography and percutaneous coronary intervention.
Related Concept Videos
01:11Assessment of radial pulse
The radial pulse, located at the wrist, is often the preferred site for assessing peripheral pulse because of its accessibility and dependability. The process of determining the radial pulse involves several steps:
01:12Arteries of the Upper Limbs
01:25Assessment of apical radial pulse
The A-R pulse assessment involves simultaneous evaluation of the apical and radial pulses. When the apical and radial pulse rates vary, this assessment helps identify a pulse deficit.
Pre-Procedural Preparation