International Hand Function Study Following Distal Radial Access: The RATATOUILLE Study.

Area of Science:

• Cardiovascular Interventions
• Vascular Access Procedures
• Hand Function Assessment

Background:

• Distal radial access (DRA) is proposed to enhance procedural ergonomics and radial artery patency.
• Limited data exists on the impact of DRA on long-term hand function.

Purpose of the Study:

• To comprehensively evaluate hand function in patients undergoing DRA.
• To assess motor and sensory function, and patient-reported outcomes post-DRA.

Main Methods:

• Multimodality assessment including questionnaires (DASH, Levine-Katz), pinch grip, and Semmes-Weinstein monofilaments test.
• Assessments performed at baseline and 1-, 6-, and 12-month follow-up in 313 patients across 9 centers.
• Documentation of adverse clinical and procedural events.

Main Results:

• Slight improvements observed in DASH and Levine-Katz scores from baseline to follow-up.
• Mild improvements in pinch strength and touch pressure threshold in both hands.
• No significant differences in hand function between the DRA and contralateral hands; no worsening of function over time.
• Access-related adverse events (bleedings, occlusions) did not impact hand function.

Conclusions:

• Distal radial access is not associated with hand function impairment.
• DRA is a safe alternative vascular access with no detrimental effects on hand motor or sensory function.