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Aymen Noamen1, Ahmed Ben Amara1, Houssem Ben Ayed1

  • 1Department of Cardiology, Military hospital of Tunis, Faculty of Medicine of Tunis, University of Tunis El Manar, Tunisia.

La Tunisie Medicale
|February 19, 2024
PubMed
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The distal radial approach (DRA) is as effective as the conventional radial approach (CRA) for percutaneous coronary interventions (PCI), showing similar puncture success and radial artery occlusion rates. This study supports DRA as a safe alternative for PCI procedures.

Area of Science:

  • Cardiology
  • Interventional Cardiology
  • Vascular Access

Background:

  • The conventional radial approach (CRA) is standard for percutaneous coronary interventions (PCI) but carries a risk of radial artery occlusion (RAO).
  • The distal radial approach (DRA) presents a viable alternative with a potentially lower complication rate.

Purpose of the Study:

  • To assess the efficacy and safety of the DRA compared to CRA in elective PCI procedures.
  • Specifically, to evaluate puncture success rates and the incidence of RAO at 30 days in a Tunisian patient cohort.

Main Methods:

  • A randomized controlled non-inferiority trial was conducted involving patients undergoing elective PCI.
  • Primary endpoints included puncture success rate and RAO rate at 30 days post-procedure.

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Main Results:

  • Puncture success rates were comparable between CRA (97.6%) and DRA (96.8%).
  • Radial artery occlusion (RAO) rates were also similar, with 2.4% in CRA and 3.2% in DRA.
  • Overall bleeding and vascular complications did not differ significantly between the two approaches.

Conclusions:

  • The distal radial approach (DRA) is non-inferior to the conventional radial approach (CRA) for elective PCI in Tunisian patients concerning puncture success and RAO rates.
  • Further multicenter trials are recommended, particularly for urgent PCI cases and incorporating systematic ultrasound for RAO screening.