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Hand Dysfunction After Intervention via Distal Versus Conventional Transradial Access: A Meta-Analysis of Randomized

Xinyu Fan1, Tong Zhou2, Feng Li2

  • 1Changzhou Wujin People's Hospital, Changzhou Medical Center, Nanjing Medical University, Changzhou, Jiangsu Province, China.

Clinical Cardiology
|May 12, 2026
PubMed
Summary

Distal transradial access (dTRA) may reduce hand clumsiness and pain after percutaneous coronary intervention (PCI) compared to conventional transradial access (TRA). However, dTRA might increase the risk of temporary hand numbness.

Keywords:
distal transradial accesshand dysfunctionrandomized trialstransradial access

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Area of Science:

  • Cardiovascular Interventions
  • Vascular Access Techniques
  • Patient Outcomes Research

Background:

  • Percutaneous coronary intervention (PCI) is a key treatment for coronary artery disease (CAD).
  • Distal transradial access (dTRA) is emerging as an alternative to traditional transradial access (TRA).
  • Both TRA and dTRA can potentially lead to post-procedural hand dysfunction.

Purpose of the Study:

  • To compare the incidence of hand dysfunction and vascular complications between dTRA and TRA.
  • To evaluate the safety and efficacy of dTRA versus TRA in cardiovascular interventions.

Main Methods:

  • A systematic review and meta-analysis of 11 randomized controlled trials (RCTs) from PubMed and Web of Science.
  • Evaluation of hand motor and sensory dysfunction, nerve injury, and radial artery occlusion (RAO).

Main Results:

  • dTRA may be associated with lower risks of hand motor dysfunction and persistent pain compared to TRA.
  • A potentially higher incidence of temporary hand numbness was observed with dTRA within 24 hours post-procedure.
  • dTRA demonstrated a significantly lower risk of radial artery occlusion (RAO) than TRA.

Conclusions:

  • dTRA offers potential advantages over TRA, including reduced hand clumsiness, persistent pain, RAO, and arteriovenous fistula (AVF) formation.
  • Clinicians should be aware of the potentially higher, though likely transient, risk of hand numbness with dTRA.