scholarly journals Anatomic Basis and Physiological Rationale of Distal Radial Artery Access for Percutaneous Coronary and Endovascular Procedures

2018 ◽  
Vol 11 (20) ◽  
pp. 2113-2119 ◽  
Author(s):  
Gregory A. Sgueglia ◽  
Angela Di Giorgio ◽  
Achille Gaspardone ◽  
Avtandil Babunashvili
Author(s):  
Jianhua Fan

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.


2020 ◽  
Vol 18 (2) ◽  
pp. 259-262
Author(s):  
Arun Maskey ◽  
Birat Krishna Timalsena ◽  
Sheikh Aslam ◽  
Rabindra Pandey ◽  
Madhu Roka ◽  
...  

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


2019 ◽  
Vol 40 (Supplement_1) ◽  
Author(s):  
T Izumikawa ◽  
S Takeshita ◽  
T Yamada ◽  
Y Mizuguchi ◽  
N Taniguchi ◽  
...  

Abstract Background The distal transradial approach (dTRA) for coronary catheterisation is a newly introduced alternative to the conventional transradial approach. This technique is expected to decrease the incidence of haemorrhagic complications and improve patient comfort. However, limited data are available regarding the application of this technique in patients with acute myocardial infarction (AMI). This study investigated the feasibility and safety of the dTRA for primary percutaneous coronary intervention (PCI) in patients with AMI. Methods This study included patients with AMI who underwent primary PCI via the distal radial artery across 3 Japanese hospitals between January 2018 and January 2019. Patients' background, procedural characteristics, and clinical outcomes including the incidence of haemorrhagic complications were analysed. Results This study enrolled 95 consecutive patients with AMI, including 68 patients (71.6%) with ST-segment elevation myocardial infarction (STEMI), in whom distal radial artery puncture was attempted for primary PCI. The patients included 70 men (73.7%), and the mean age was 72.2±12.4 years. Among these patients, cannulation was successfully performed in 89 patients (93.7%). A 5-, 6-, or 7-French sheath (conventional or slender) was used in this study. Cannulation was performed using a forearm radial artery approach in patients in whom dTRA failed. PCI was successfully performed in all patients. The meantime to achieve haemostasis was 6.3±5.3 hours, and no major bleeding complications occurred. Based on The Early Discharge After Transradial Stenting of Coronary Arteries trial haematoma scale, grade I, II, and III subcutaneous haemorrhages were observed in 16 (16.8%), 4 (4.2%), and 1 patient (1.1%), respectively. No patient developed a haematoma > grade IV. In patients with STEMI, the mean door-to-balloon time was 39.4±31.9 min, and the mean puncture-to-balloon time was 19.7±14.2 min. Conclusions The distal radial approach is feasible and safefor primary PCI in selected patients with AMI.The application of the dTRA may serve as a less invasive strategy for the treatment of patients with AMI.


2020 ◽  
Vol 5 (2) ◽  
pp. 103-107
Author(s):  
Wen Pan ◽  
Haixiang Xu ◽  
Qingjun Liu ◽  
Jianhua Fan

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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