Related Experiment Video
Updated: Oct 4, 2025
Transradial Access Chemoembolization for Hepatocellular Carcinoma Patients
Published on: September 20, 2020
Distal radial approach between theory and clinical practice.. Time to go distal!
Mohamed I Sanhoury1, Mohamed A Sobhy1, Mohamed A Saddaka1
1Department of Cardiology and Angiology, Faculty of Medicine, Alexandria University, Alexandria, Egypt.
Insights
Distal transradial access (d-TRA) is a safe and promising technique for cardiac catheterization, offering benefits over standard transradial access (TRA) with a lower risk of radial artery blockage. Further research is needed to optimize its application.
Area of Science:
- Cardiovascular Interventions
- Vascular Access Techniques
Background:
- Transradial access (TRA) is the standard for cardiac catheterization due to its low complication rates.
- Distal transradial access (d-TRA) is an emerging technique for coronary interventions.
- Evaluating d-TRA against conventional TRA is crucial for understanding its potential.
Purpose of the Study:
- To introduce distal transradial access (d-TRA) as a novel cardiac catheterization technique.
- To compare the efficacy and safety of d-TRA versus conventional transradial access (TRA).
- To explore the benefits and drawbacks of d-TRA in Alexandria University.
Main Methods:
- A randomized study comparing d-TRA and TRA in 100 patients undergoing coronary interventions.
- Patients were allocated to either d-TRA (50 patients) or TRA (50 patients) using systematic random sampling.
- Primary and secondary endpoints were used to evaluate procedural success and safety profiles.
Main Results:
- TRA showed statistically significant advantages in procedural success, access time, and total procedural time.
- d-TRA demonstrated statistically significant improvements in safety, with less post-operative hematoma, AV fistula, pain, and shorter compression time.
- No significant difference in radial artery occlusion (RAO) between groups, though it was more frequent in the TRA group.
Conclusions:
- Distal radial approach (d-TRA) is a viable and safe alternative for coronary angiography and interventions.
- d-TRA presents a lower risk of radial artery blockage compared to TRA, with comparable rates of hematoma and spasm.
- The success of d-TRA is influenced by operator experience and case selection.
Background:
Transradial access (TRA), which has a minimal risk of problems such as radial artery occlusion (RAO), hemorrhage, spasm, and so on, is now considered the standard procedure for cardiac catheterization. The aim of the study is to present the distal transradial access (d-TRA) as a possible promising novel technique in the field of cardiac coronary interventions comparing it to the standard conventional TRA using primary and secondary endpoints, exploring its benefits and drawbacks as a new experience in Alexandria University. One hundred cases with variable indications for coronary interventions were randomized to two arms using systematic random sampling method, coronary interventions in the first one were done via d-TRA (50 patients) and in the second arm via conventional TRA group (50 patients).
Results:
Technically, there were highly statistically significant differences between the two arms in favor of TRA regarding procedural success, number of punctures taken, Access time, Total procedural time, vasodilator used, and crossover to another access site; meanwhile safety profile parameters have showed statistically significant differences in favor of d-TRA regarding post-operative hematoma, AV fistula, post-operative pain and compression time, and there were no statistically significant differences regarding RAO although it occurred more in TRA group.
Conclusions:
In the realm of cardiac intervention, the distal radial approach is a promising technique. When compared to TRA, we found it to be a viable and safe method for coronary angiography and interventions and it could be a real option for the interventionists in the near future, with a lower risk of radial artery blockage and no significant differences in wrist hematoma and radial artery spasm. The success rate of d-TRA is proportional to the steepness of the operator's learning curve and the quality of the examples chosen.
More Related Videos
10:36Vascularized Composite Hand Allograft Procurement and Preparation for Distal and Proximal Forearm Allotransplantation: A Stepwise Approach
Published on: May 23, 2025
05:04Author Spotlight: Evaluating Clinicians' Adoption of Ultrasound-Guided Vascular Cannulation Through Simulation Training
Published on: August 9, 2024
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:
01:09Bones of the Upper Limb: Radius
The radius has a nail-shaped head, and a...
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
01:27Peripheral Artery Disease III: Interprofessional Care
01:15Bones of the Upper Limb: Ulna
01:12Arteries of the Upper Limbs