CORRECT RADIAL RCT. CORonaRy angiography and intErventions via distal vs proximal transradial aCcess-a randomized...

Area of Science:

• Cardiology
• Vascular Access Techniques

Background:

• Transradial access (TRA) is the recommended primary route for coronary angiography (CAG) and percutaneous coronary intervention (PCI).
• Distal radial access (dRA), a more distal puncture site in the anatomical snuffbox, has emerged as an alternative to traditional proximal radial access (pRA).

Purpose of the Study:

• To evaluate the superiority of dRA over pRA in reducing the rate of radial artery occlusion (RAO) after CAG or PCI.
• To compare secondary outcomes including crossover rates, hand function, and procedure duration between dRA and pRA.

Main Methods:

• A randomized multicenter trial involving 254 patients undergoing CAG or PCI in five German cardiology centers.
• Patients were randomized to either standard pRA or dRA.
• Radial artery patency was assessed by ultrasound at 48 hours and 30 days post-procedure.

Main Results:

• The trial was halted prematurely after enrolling 50% of the planned population.
• Radial artery occlusion (RAO) occurred in 0.9% of the dRA group versus 2.8% in the pRA group, a difference that was not statistically significant (P=0.36).
• Puncture success rates were high (94% overall) with no significant difference between dRA (91%) and pRA (98%); no major complications were reported.

Conclusions:

• Distal radial access (dRA) did not demonstrate a statistically significant reduction in radial artery occlusion (RAO) rates compared to proximal radial access (pRA) for coronary interventions.
• The study suggests that dRA is a safe alternative with comparable puncture success and complication rates to pRA.