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Diabetes and Risk of Radial Artery Occlusion After Distal Radial Access: Insights From the KODRA Registry

Byung Gyu Kim1, Hyun Cho2, Sung Eun Kim2

  • 1CPC Clinical Research, Department of Medicine, University of Colorado Anschutz School of Medicine, Aurora, CO, USA; Division of Cardiology, Department of Internal Medicine, Sanggye Paik Hospital, School of Medicine, Inje University, Seoul, Republic of Korea.

Heart, Lung & Circulation
|July 1, 2026
PubMed

Insights

Distal radial access (DRA) is safe for patients with diabetes, showing similar rates of radial artery occlusion (RAO) and bleeding compared to non-diabetic patients. These findings support DRA as a viable option for this population.

Area of Science:

  • Cardiology
  • Vascular Access
  • Diabetes Mellitus

Background:

  • Distal radial access (DRA) is increasingly utilized for coronary angiography (CAG) and percutaneous coronary intervention.
  • Limited evidence exists regarding DRA safety and efficacy in patients with diabetes.

Purpose of the Study:

  • To investigate the association between diabetes and forearm radial artery occlusion (RAO) after DRA.
  • To compare procedural success and safety outcomes of DRA in diabetic versus non-diabetic patients.

Main Methods:

  • Analysis of 4,941 patients from the multicenter KODRA registry undergoing attempted DRA.
  • Comparison of RAO rates at 1 month, DRA-related bleeding, puncture success, and CAG success between diabetic (n=1,813) and non-diabetic (n=3,128) groups.

Main Results:

  • Diabetic patients had comparable rates of RAO (0.5% vs 0.8%; p=0.139) and DRA-related bleeding (3.0% vs 3.4%; p=0.535) to non-diabetic patients.
  • Puncture success (94.1% vs 94.5%) and successful CAG without crossover (98.9% vs 98.8%) were similar between groups.
  • Multivariable analysis indicated diabetes was not an independent predictor of RAO or other secondary end points.

Conclusions:

  • DRA demonstrates comparable safety and efficacy in patients with and without diabetes.
  • DRA is a safe and feasible vascular access strategy for diabetic patients undergoing CAG and PCI.
  • Standardized techniques are crucial for preserving radial artery patency.
Abstract

Keywords:
DiabetesDistal radial accessRadial artery occlusion

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