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Related Experiment Video

Updated: Jan 8, 2026

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Distal transradial access for percutaneous coronary intervention: a single-center randomized controlled study (DRAGON

Minghao Liu1, Yuan Du1, Cheng Cui1

  • 1Department of Cardiology, Fuwai Hospital, Chinese Academy of Medical Sciences, Beijing, China.

BMC Cardiovascular Disorders
|December 24, 2025
PubMed
Summary

Distal transradial access (dTRA) significantly reduces radial artery occlusion (RAO) after percutaneous coronary intervention (PCI) compared to traditional transradial access (TRA). This approach also shortens hemostasis time without impacting procedural success.

Keywords:
Distal transradial accessPercutaneous coronary interventionPostoperative hand function recoveryTransradial access

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Area of Science:

  • Cardiology
  • Vascular Surgery
  • Interventional Cardiology

Background:

  • Transradial access (TRA) is standard for coronary interventions due to lower bleeding risk and better patient comfort.
  • Radial artery occlusion (RAO) limits re-use of the radial artery for future procedures.
  • Distal transradial access (dTRA) is investigated to decrease RAO while maintaining procedural efficacy.

Purpose of the Study:

  • To evaluate if distal transradial access (dTRA) reduces early and mid-term radial artery occlusion (RAO) compared to conventional transradial access (TRA).
  • To assess the impact of dTRA on procedural success, hemostasis time, radiation exposure, and hand/wrist function in patients undergoing percutaneous coronary intervention (PCI).

Main Methods:

  • A single-center, prospective, randomized superiority trial included 426 patients undergoing elective PCI.
  • Patients were assigned 1:1 to either dTRA (n=213) or TRA (n=213).
  • Radial artery occlusion (RAO) was assessed using duplex ultrasonography at 24 hours and 30 days post-procedure.

Main Results:

  • The 24-hour RAO rate was significantly lower in the dTRA group (0.5%) versus the TRA group (8.7%; p<0.001).
  • At 30 days, RAO remained significantly lower with dTRA (1.6%) compared to TRA (8.2%; p<0.001).
  • Median hemostasis time was shorter with dTRA (3.0 hours) versus TRA (6.0 hours; p<0.001), with comparable procedural success and radiation exposure.

Conclusions:

  • Distal transradial access (dTRA) significantly reduces RAO incidence and shortens hemostasis time compared to TRA in elective PCI.
  • dTRA does not compromise procedural success or increase radiation exposure.
  • The findings support the routine adoption of dTRA for coronary interventions, with modest improvements in early hand function.