Related Experiment Video
Updated: Sep 11, 2025
Transradial Access Chemoembolization for Hepatocellular Carcinoma Patients
Published on: September 20, 2020
Distal versus conventional transradial artery access for coronary catheterization in patients with STEMI (DR-STEMI):
Grigorios Tsigkas1, Aikaterini Trigka-Vasilakopoulou1, Anastasios Apostolos2
1Department of Cardiology, University Hospital of Patras, Patras, Greece.
Insights
Distal transradial access (dTRA) is being compared to conventional transradial access (TRA) in ST-elevation myocardial infarction (STEMI) patients. This trial evaluates dTRA safety and efficacy for cardiac procedures in STEMI patients.
Area of Science:
- Cardiology
- Interventional Cardiology
- Vascular Access
Background:
- Transradial access (TRA) is the standard for cardiac catheterization, recommended by guidelines for all patients.
- Distal transradial access (dTRA) has shown feasibility and safety in chronic and acute coronary syndromes, but not yet in ST-elevation myocardial infarction (STEMI).
Purpose of the Study:
- To compare distal transradial access (dTRA) versus conventional transradial access (TRA) in patients with STEMI undergoing coronary procedures.
- To determine if dTRA is non-inferior to TRA in terms of needle-to-wire time for STEMI patients.
Main Methods:
- DR-STEMI is a prospective, open-label, multicenter randomized controlled trial.
- 554 STEMI patients will be randomized (1:1) to either dTRA or TRA.
- The primary endpoint is the time from radial artery puncture to guidewire crossing of the infarct-related artery.
Main Results:
- Enrollment began in May 2024, with 309 patients enrolled as of April 15, 2025.
- Recruitment is ongoing and expected to continue for approximately 12 months.
- Full results are pending completion of patient enrollment and follow-up.
Conclusions:
- The DR-STEMI trial is investigating the efficacy and safety of dTRA in STEMI patients.
- Findings will inform guideline recommendations for radial access in acute myocardial infarction.
- This study aims to establish dTRA as a viable alternative for STEMI interventions.
Rationale:
Transradial access (TRA) constitutes the cornerstone for cardiac catheterization and is recommended by the multiple recent guidelines, irrespective of clinical presentation. The existing literature has evaluated distal transradial access (dTRA), as a feasible and safe approach in patients with chronic and acute coronary syndrome, excluding although patients presenting with ST- elevation myocardial infraction (STEMI).
Primary Hypothesis:
The current randomized clinical trial compares dTRA versus conventional TRA access in patients with STEMI undergoing coronary angiography and interventions regarding peri‑ and postprocedural characteristics.
Design:
DR-STEMI is a prospective, open label, European, multicenter randomized-control trial which will include 554 patients (277 patients in each treatment arm). Patients with STEMI, will be screened on an all-comers basis for study inclusion and exclusion criteria, and those eligible will be allocated randomly (1:1), to dTRA versus TRA approach. The primary hypothesis of the study is that dTRA is noninferior to conventional TRA regarding the required time between the puncture of the radial artery and wire crossing of the infarct-related artery (i.e., needle-to-wire time).
Current Status:
Enrollment for the DR-STEMI trial began in May 2024, and as of April 15th, 2025, 309 patients have been enrolled in the study. Recruitment is expected to continue for approximately 12 months.
Trial Registration:
clinicaltrials.gov: NCT05605288.
More Related Videos
06:02Upper-extremity Approach for Secondary Access in Transfemoral Transcatheter Aortic Valve Implantation
Published on: August 8, 2025
07:25Predicting Amputation using Local Circulating Mononuclear Progenitor Cells in Angioplasty-treated Patients with Critical Limb Ischemia
Published on: September 22, 2020
Related Concept Videos
01:30Acute Coronary Syndrome I: Introduction
01:24Cardiac Catheterization III: Left Heart Catheterization
01:28Cardiac Catheterization I: Pre-Procedure Overview
01:27Peripheral Artery Disease III: Interprofessional Care
01:21Cardiac Catheterization II: Right Heart Catheterization
01:27Coronary Artery Disease V: Interprofessional Care