Distal Radial Artery Approach to Prevent Radial Artery Occlusion Trial

Area of Science:

• Cardiovascular Interventions
• Vascular Access Techniques
• Radial Artery Imaging

Background:

• Proximal radial artery occlusion (RAO) is a potential complication following transradial coronary procedures.
• The efficacy of distal radial access in preventing proximal RAO has not been well-established.

Purpose of the Study:

• To compare the incidence of proximal RAO between distal and conventional radial artery access.
• To evaluate the effectiveness of distal radial access in preventing RAO at 24 hours and 30 days post-procedure.

Main Methods:

• A prospective, randomized, comparative study involving 282 patients.
• Patients were randomized to either proximal radial access (n=142) or distal radial access (n=140).
• Doppler ultrasound was used to assess for PRAO at 24 hours and 30 days post-transradial coronary procedure.

Main Results:

• The per-protocol analysis showed significantly lower PRAO rates with distal access (0.7% at 24h and 30 days) compared to proximal access (8.4% at 24h, 5.6% at 30 days).
• Intention-to-treat analysis also demonstrated superior PRAO prevention with distal access (1.2% at 24h, 0.6% at 30 days) versus proximal access (8.8% at 24h, 6.4% at 30 days).
• Odds ratios indicated a substantially higher likelihood of PRAO with proximal access.

Conclusions:

• Distal radial access is effective in preventing proximal radial artery occlusion.
• The study demonstrates the superiority of distal radial access over conventional radial access in reducing RAO rates post-coronary procedures.