Feasibility and Safety of Distal Radial Artery Access in Anatomical Snuffbox for Coronary Angiography and Coronary Intervention

Background: There is limited data on feasibility and safety of coronary interventions performed using radial artery at anatomical snuffbox as vascular access point in South Asian region. Our study attempts to evaluate the feasibility and safety of coronary angiography and percutaneous coronary intervention using transradial access at anatomical snuffbox.Methods: Transradial access at anatomical snuffbox was attempted in 128 consecutive patients, who were planned for coronary angiography and/or percutaneous coronary intervention. Success in vascular access, completion of planned procedure and complications encountered, including patency of radial artery after the procedure, were investigated. Results: A total of 128 patients (76 males [59.4%]; 52 females [40.6%]) between 44-78 years of age (mean age, 59.0 +/- 10.2 years) were included in the study. Distal radial artery puncture and sheath placement was successful in all patients however planned procedure was completed in 126 (98.4%) patients. Total 90 coronary angiographies and 36 percutaneous coronary interventions were performed of which five were primary percutaneous coronary intervention. We encountered brachial artery spasm among two patient (1.5%) and significant pain and swelling among three patients (2.3%). No bleeding complication, numbness or parasthesia were observed on follow-up. Patients had average pain rating of 2.4+/- 1.1 in visual analogue pain rating scale. There were no instances of radial artery occlusion after the procedure.Conclusions: Distal radial artery, at anatomical snuffbox, is a safe and feasible alternative vascular access site for coronary angiography and percutaneous coronary intervention. Keywords: Cardiac catheter; coronary angiography; feasibility studies; percutaneous coronary intervention; radial artery; vascular access device

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Comparison of Clinical Value between Right Distal Radial Artery Access and Right Radial Artery Access in Patients Undergoing Coronary Angiography or Percutaneous Coronary Intervention

Cardiovascular Innovations and Applications ◽

10.15212/civa.2019.0592 ◽

2020 ◽

Author(s):

Jianhua Fan

Keyword(s):

Percutaneous Coronary Intervention ◽

Coronary Angiography ◽

Radial Artery ◽

Coronary Intervention ◽

Access Time ◽

Arterial Access ◽

Compression Time ◽

Percutaneous Coronary ◽

The Right ◽

Distal Radial Artery

Objective: To compare the feasibility and safety between right distal radial artery access and right radial artery accessin patients undergoing coronary angiography (CAG) or percutaneous coronary intervention (PCI).Methods: On the basis of arterial access, 113 patients who underwent CAG or PCI in Kunshan Hospital of TraditionalChinese Medicine between January and October 2018 were divided into two groups: a right distal radial artery group (52 patients) and a right radial artery group (61 patients). We collected general information, the number of puncture attempts, access times, postoperative compression time, and complications.Results: The general characteristics, rate of successful radial artery puncture, and rate of successful catheter placement inthe two groups were not different. The right radial artery group had fewer puncture attempts (1.26 ± 0.44 times vs. 2.19 ± 0.53times, P = 0.001) and a shorter access time (3.23 ± 0.86 min vs. 4.77 ± 1.49 min, P = 0.001) than the right distal radial arterygroup. However, the postoperative compression time in the right distal radial artery group was shorter (3.44 ± 0.9 h vs.7.16 ± 1.21 h, P = 0.001). Two cases of bleeding, four cases of hematoma, and one case of artery occlusion in the right radialartery group and one case of hematoma in the right distal artery group occurred before discharge. The rate of total complicationsin the right distal radial artery group was lower than in the right radial artery group (1.93% vs. 11.48%, P = 0.048).Conclusion: CAG or PCI through the right distal radial artery is feasible and safe.

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Recanalization of the occluded radial artery via distal transradial access in the anatomic snuffbox

BMC Cardiovascular Disorders ◽

10.1186/s12872-021-01890-1 ◽

2021 ◽

Vol 21 (1) ◽

Author(s):

Feng Li ◽

Gan-Wei Shi ◽

Bi-Feng Zhang ◽

Xiao-Long Yu ◽

Hao-Min Huang ◽

...

Keyword(s):

Percutaneous Coronary Intervention ◽

Coronary Angiography ◽

Radial Artery ◽

Coronary Intervention ◽

Artery Occlusion ◽

Transradial Access ◽

Vascular Ultrasonography ◽

Percutaneous Coronary ◽

Radial Artery Occlusion ◽

The Right

Abstract Background Radial artery occlusion is a common complication after coronary angiography and percutaneous coronary intervention via the transradial access. In recent years, coronary angiography and percutaneous coronary intervention via the distal transradial access has gradually emerged, but recanalization of the occluded radial artery through the distal transradial access has rarely been reported. Case presentation A 67-year-old female with arterial hypertension and diabetes mellitus was admitted to the hospital due to chest pain for three hours. She was diagnosed with acute myocardial infarction. After admission, the patient successfully underwent emergency coronary angiography and percutaneous coronary intervention through the right transradial access. Radial artery occlusion was found after the operation, and recanalization was successfully performed through the right distal transradial access before discharge. Immediately after the operation and one month later, vascular ultrasonography showed that the antegrade flow was normal. Conclusions This report presents a case of radial artery occlusion after emergency coronary angiography and percutaneous coronary intervention in which recanalization was successfully performed through the right distal transradial access. This case demonstrates that recanalization of a radial artery occlusion via the distal transradial access is safe and feasible.

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Distal Transradial Access For Percutaneous Coronary Intervention And Coronary Angiography : Advances In Interventional Cardiology

KYAMC Journal ◽

10.3329/kyamcj.v11i3.49875 ◽

2020 ◽

Vol 11 (3) ◽

pp. 154-157

Author(s):

SM Taslim Yusuf Tamal ◽

Steven Huang ◽

Md Saiful Islam ◽

SK Yunus Ali

Keyword(s):

Percutaneous Coronary Intervention ◽

Coronary Angiography ◽

Radial Artery ◽

Interventional Cardiology ◽

Coronary Intervention ◽

Comfort Level ◽

New Technique ◽

Transradial Access ◽

Number Of Patients ◽

Percutaneous Coronary

Since its' introduction in 2017, Distal Transradial Access (dTRA) has shown it's advantages over conventional Transradial Approach in terms of risk with Radial Artery Occlusion (RAO) and with the comfort level for both the patient and operator. A large number of patients requiring subsequent intervention gets much benefit with this new technique of Radial Artery (RA) preservation, as it is a refinement of the conventional approach. On the other hand, the most challenging part it has is the supreme level of expertise for a successful puncture for the advancement with the procedure. Still, this new technique has been obtained by the Interventionists world wide with the simultaneous study on it to make the distal transradial access as a default access site for routine Coronary Angiography (CAG) and Percutaneous Coronary Intervention (PCI). For evaluation with the real world feasibility and safety along with the comfort for both the operator and patient, this study has been conducted. KYAMC Journal Vol. 11, No.-3, October 2020, Page 154-157

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Comparison of Clinical Value between Right Distal Radial Artery Access and Right Radial Artery Access in Patients Undergoing Coronary Angiography or Percutaneous Coronary Intervention

Cardiovascular Innovations and Applications ◽

10.15212/cvia.2019.0592 ◽

2020 ◽

Vol 5 (2) ◽

pp. 103-107

Author(s):

Wen Pan ◽

Haixiang Xu ◽

Qingjun Liu ◽

Jianhua Fan

Keyword(s):

Percutaneous Coronary Intervention ◽

Coronary Angiography ◽

Radial Artery ◽

Coronary Intervention ◽

Access Time ◽

Arterial Access ◽

Compression Time ◽

Percutaneous Coronary ◽

The Right ◽

Distal Radial Artery

Objective: To compare the feasibility and safety between right distal radial artery access and right radial artery access in patients undergoing coronary angiography (CAG) or percutaneous coronary intervention (PCI).Methods: On the basis of arterial access, 113 patients who underwent CAG or PCI in Kunshan Hospital of Traditional Chinese Medicine between January and October 2018 were divided into two groups: a right distal radial artery group (52 patients) and a right radial artery group (61 patients). We collected general information, the number of puncture attempts, access times, postoperative compression time, and complications.Results: The general characteristics, rate of successful radial artery puncture, and rate of successful catheter placement in the two groups were not different. The right radial artery group had fewer puncture attempts (1.26±0.44 times vs. 2.19±0.53 times, P=0.001) and a shorter access time (3.23±0.86 min vs. 4.77±1.49 min, P=0.001) than the right distal radial artery group. However, the postoperative compression time in the right distal radial artery group was shorter (3.44±0.9 h vs. 7.16±1.21 h, P=0.001). Two cases of bleeding, four cases of hematoma, and one case of artery occlusion in the right radial artery group and one case of hematoma in the right distal artery group occurred before discharge. The rate of total complications in the right distal radial artery group was lower than in the right radial artery group (1.93% vs. 11.48%, P=0.048).Conclusion: CAG or PCI through the right distal radial artery is feasible and safe.

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