Effectiveness and Safety of Left Distal Transradial Access in Coronary Procedures in the Caribbean

Area of Science:

• Cardiology
• Vascular Access
• Interventional Cardiology

Background:

• Cardiovascular disease remains a significant health concern globally and in the Caribbean.
• Transradial access is a preferred method for coronary angiography and intervention due to its safety profile.
• Left distal transradial access (LDTRA) is an emerging technique with potential benefits.

Purpose of the Study:

• To evaluate the effectiveness and safety of LDTRA compared to standard left transradial access (LTRA).
• To assess procedural outcomes, including technical success, duration, and complications, in patients undergoing coronary procedures.
• To determine the clinical utility of LDTRA in a Caribbean healthcare setting.

Main Methods:

• A retrospective study involving 111 patients undergoing coronary angiography (CAG) or percutaneous coronary intervention (PCI).
• Patients were divided into two groups: LDTRA (n=88) and LTRA (n=23).
• Data collected included procedural success, fluoroscopy time, procedural duration, hemostasis time, and vascular complications like radial artery occlusion (RAO).

Main Results:

• No significant difference in technical success rates between LDTRA (90.9%) and LTRA (100%), p=0.202.
• LDTRA demonstrated significantly shorter fluoroscopy times (p=0.02), procedural duration (p=0.04), and hemostasis time (p<0.05).
• No significant difference in procedural complications (8% vs. 4.3%, p=0.476) or reported cases of RAO.

Conclusions:

• LDTRA is an effective and safe alternative for coronary procedures, comparable to LTRA.
• LDTRA offers advantages in reduced procedure and hemostasis times, potentially improving patient throughput.
• The findings suggest LDTRA is clinically relevant for cardiovascular interventions in resource-limited environments like the Caribbean.