Feasibility and Safety of the Distal Transradial Artery for Coronary Diagnostic or Interventional Catheterization

Area of Science:

• Cardiology
• Vascular Surgery
• Interventional Cardiology

Background:

• Transradial artery (TRA) catheterization is a common approach for coronary angiography and percutaneous coronary interventions.
• The distal transradial artery (dTRA) approach is a modification of TRA, aiming to improve outcomes.
• This study prospectively compares the safety and efficacy of dTRA versus conventional TRA.

Purpose of the Study:

• To compare the success rate and safety of the distal transradial artery (dTRA) approach versus the conventional transradial artery (TRA) approach.
• To evaluate complications associated with each approach.
• To identify risk factors for access failure in the dTRA group.

Main Methods:

• A prospective study involving 900 consecutive patients undergoing coronary angiography or percutaneous coronary interventions.
• Patients were randomly assigned to either dTRA or conventional TRA catheterization.
• Data on success rates, procedural times, hemostatic device usage, and complications were collected and analyzed.

Main Results:

• Successful access rates were comparable between dTRA (96.00%) and TRA (96.67%).
• The dTRA group showed significantly reduced hemostatic band removal time, minor bleeding, hemostatic band cost, and postprocedural radial artery occlusion compared to the TRA group.
• Lower body mass index (BMI < 22.04 kg/m²) was identified as a risk factor for dTRA access failure.

Conclusions:

• The dTRA approach demonstrates a comparable success rate to conventional TRA for coronary interventions.
• dTRA is associated with fewer complications, reduced costs, and faster hemostasis.
• Clinicians should exercise caution when using the dTRA approach in patients with a low body mass index.