Distal Radial Artery Access for Coronary and Peripheral Procedures: A Multicenter Experience

Area of Science:

• Cardiovascular Interventions
• Vascular Access Techniques

Background:

• Distal radial access (dRA) is emerging as a preferred vascular access route due to benefits like reduced bleeding and radial artery occlusion.
• Patient and operator comfort are improved with dRA compared to traditional access methods.

Purpose of the Study:

• To evaluate the feasibility and safety of distal radial artery access (dRA) in a large multicenter registry.
• To assess dRA's utility across a spectrum of routine catheterization laboratory procedures, including coronary and noncoronary interventions.

Main Methods:

• A registry of 1240 patients undergoing procedures via dRA between January 2019 and April 2021 in two Hungarian centers.
• Analysis included patient demographics, procedural success, access site crossover, complications, and learning curve assessment.
• Ultrasound guidance was used for all dRA punctures.

Main Results:

• Successful dRA puncture was achieved in 97% of patients, with a procedural success rate plateauing above 96% after 150 cases.
• The rate of access site crossover was low at 2.58%.
• High patency of the radial artery (RA) was observed (99.68% palpable pulses at discharge), with a low rate of minor vascular complications (1.5%).
• A learning curve of approximately 50 cases was sufficient for skilled radial operators to master dRA.

Conclusions:

• Distal radial artery access is a feasible and safe approach for routine use in catheterization laboratories.
• The implementation of dRA for both coronary and noncoronary interventions is supported by this study's findings.
• An acceptable learning curve allows for widespread adoption of dRA techniques.