Impact of Anthropometric Measures on Distal vs Conventional Radial Access for Percutaneous Coronary Procedures

Area of Science:

• Cardiology
• Interventional Cardiology
• Vascular Access

Background:

• The Distal vs Conventional Radial Access (DISCO RADIAL) trial established distal radial access (DRA) as a viable alternative to conventional transradial access.
• Both methods demonstrated comparable low rates of radial artery occlusion (RAO).
• DRA showed higher crossover rates but shorter hemostasis times compared to conventional access.

Purpose of the Study:

• To evaluate if patient anthropometric measures influence secondary outcomes in randomized vascular access.
• To determine the impact of weight, height, BMI, and BSA on access-related complications.

Main Methods:

• An international, multicenter randomized controlled trial (DISCO RADIAL) involving 1307 patients undergoing percutaneous coronary procedures.
• Patients were randomized to DRA or conventional transradial access using a 6-F Slender sheath.
• Regression models analyzed the influence of anthropometric measures on sheath insertion time, radial artery spasm, crossover, hemostasis time, and access site complications.

Main Results:

• The primary endpoint, forearm RAO, was uncommon across both access groups.
• No significant interaction effects were observed between anthropometric measures and the randomized access type on secondary outcomes.
• The main effects of vascular access on spasm, crossover, hemostasis, and complications remained consistent across different patient anthropometries.

Conclusions:

• This exploratory analysis supports the main findings of the DISCO RADIAL trial.
• Distal radial access is recommended for all patients undergoing percutaneous coronary procedures, irrespective of their anthropometric characteristics.
• Anthropometric measures do not appear to modify the clinical outcomes associated with DRA versus conventional transradial access.