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Safety and Efficacy of Distal Transradial Access in Patients With Small Diameter Distal Radial Artery: A Post Hoc
Feng Li1, Tong Zhou1, Xinyu Fan2
1Department of Cardiology, Changzhou Wujin People's Hospital, Wujin Hospital Affiliated with Jiangsu University, Changzhou, Jiangsu Province, China.
Background:
Distal transradial access (dTRA) for coronary intervention is being increasingly used, yet few studies have assessed its feasibility in patients with small distal radial artery (SDRA).
Methods:
Post hoc analysis included patients randomized to dTRA in the Comparison of long-term radial artery occlusion via distal vs conventional transradial access (CONDITION) and Comparison of the Impact of a 6 French GlideSheath Slender and a Conventional Sheath on Distal Radial Artery Occlusion (SMART) randomised control trials. Patients were divided into an SDRA group (≤2.0 mm) and a non-SDRA group (>2.0 mm).
Results:
A total of 1018 patients were included in the present study. The total puncture and procedure success rates were 93.8% and 93.5%, respectively. The SDRA group showed lower puncture (91.6% vs 96.0%, P = 0.004), first-attempt puncture (66.3% vs 73.5%, P = 0.012), and procedure success rates (91.0% vs 96.0%, P = 0.001). There was no significant difference in the incidence of radial artery occlusion between the 2 groups (2.4% vs 1.2%, P = 0.129). The incidence of distal radial artery occlusion in the SDRA group was greater than that in the non-SDRA group (4.2% vs 2.0%, P = 0.033). Additionally, there were no significant differences in the other outcomes.
Conclusion:
Based on this exploratory post hoc analysis, the dTRA is safe and effective for coronary intervention in patients with SDRA. Further studies are needed to validate these findings.
Clinical Trial Registration:
NCT05253820, NCT05501925.
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