Comparison between the Right and Left Distal Radial Access for Patients Undergoing Coronary Procedures: A Propensity...

Area of Science:

• Cardiology
• Vascular Access Techniques
• Interventional Cardiology

Background:

• Distal radial access (DRA) improves patient comfort and reduces complications compared to conventional transradial access.
• While left distal radial access (lDRA) is established, right distal radial access (rDRA) is also feasible but lacks comparative studies.

Purpose of the Study:

• To compare the vascular access and procedural performance between right distal radial access (rDRA) and left distal radial access (lDRA) for coronary procedures.

Main Methods:

• Prospective recording of coronary procedures using DRA from August 2020 to October 2021.
• Propensity score matching to compare rDRA and lDRA groups.
• Primary endpoint: approach success. Secondary endpoints: access time, procedural success, radial spasm, radiation exposure, patient comfort, and complications.

Main Results:

• After matching, 182 procedures (rDRA vs. lDRA) showed no significant difference in approach success (96.7%) or procedural success (100%).
• rDRA demonstrated a significantly shorter access time (39 sec vs. 50 sec, p=0.018) with no significant difference in radial spasm (2.19% vs. 6.59%).
• No significant differences were observed in radiation dose-area product or fluoroscopy time; no access-related complications occurred in either group.

Conclusions:

• Right distal radial access (rDRA) is a viable alternative to left distal radial access (lDRA) for coronary procedures.
• rDRA offers comparable efficacy and safety to lDRA, with the added benefit of reduced access time.