Distal radial artery access in the anatomical snuffbox for coronary angiography and intervention

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

Journal of Nepal Health Research Council ◽

10.33314/jnhrc.v18i1.2402 ◽

2020 ◽

Vol 18 (2) ◽

pp. 259-262

Author(s):

Arun Maskey ◽

Birat Krishna Timalsena ◽

Sheikh Aslam ◽

Rabindra Pandey ◽

Madhu Roka ◽

...

Keyword(s):

Percutaneous Coronary Intervention ◽

Coronary Angiography ◽

Radial Artery ◽

Vascular Access ◽

Coronary Intervention ◽

Pain Rating ◽

Coronary Interventions ◽

Transradial Access ◽

Percutaneous Coronary ◽

Distal Radial Artery

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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Distal Radial Artery Access for Coronary and Peripheral Procedures: A Multicenter Experience

Journal of Clinical Medicine ◽

10.3390/jcm10245974 ◽

2021 ◽

Vol 10 (24) ◽

pp. 5974

Author(s):

Alexandru Achim ◽

Kornél Kákonyi ◽

Zoltán Jambrik ◽

Ferenc Nagy ◽

Julia Tóth ◽

...

Keyword(s):

Coronary Angiography ◽

Success Rate ◽

Radial Artery ◽

Vascular Complications ◽

Coronary Intervention ◽

Learning Curves ◽

Bleeding Complications ◽

Entry Site ◽

Catheterization Laboratory ◽

Distal Radial Artery

Introduction: Distal radial access (dRA) has recently gained global popularity as an alternative access route for vascular procedures. Among the benefits of dRA are the low risk of entry site bleeding complications, the low rate of radial artery occlusion, and improved patient and operator comfort. The aim of this large multicenter registry was to demonstrate the feasibility and safety of dRA in a wide variety of routine procedures in the catheterization laboratory, ranging from coronary angiography and percutaneous coronary intervention to peripheral procedures. Methods: The study comprised 1240 patients who underwent coronary angiography, PCI or noncoronary procedures through dRA in two Hungarian centers from January 2019 to April 2021. Baseline patient characteristics, number and duration of arterial punctures, procedural success rate, crossover rate, postoperative compression time, complications, hospitalization duration, and different learning curves were analyzed. Results: The average patient age was 66.4 years, with 66.8% of patients being male. The majority of patients (74.04%) underwent a coronary procedure, whereas 25.96% were involved in noncoronary interventions. dRA was successfully punctured in 97% of all patients, in all cases with ultrasound guidance. Access site crossover was performed in 2.58% of the patients, mainly via the contralateral dRA. After experiencing 150 cases, the dRA success rate plateaued at >96%. Our dedicated dRA step-by step protocol resulted in high open radial artery (RA) rates: distal and proximal RA pulses were palpable in 99.68% of all patients at hospital discharge. The rate of minor vascular complications was low (1.5%). A threshold of 50 cases was sufficient for already skilled radial operators to establish a reliable procedural method of dRA access. Conclusion: The implementation of distal radial artery access in the everyday routine of a catheterization laboratory for coronary and noncoronary interventions is feasible and safe with an acceptable learning curve.

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COMPARATIVE STUDY BETWEEN CONVENTIONAL AND DISTAL RADIAL ARTERY APPROACHES FOR CORONARY ANGIOGRAPHY AND/OR INTERVENTION; IMMEDIATE AND SHORT-TERM FOLLOW UP

Al-Azhar Medical Journal ◽

10.21608/amj.2022.212884 ◽

2022 ◽

Vol 51 (1) ◽

pp. 797-808

Keyword(s):

Coronary Angiography ◽

Comparative Study ◽

Radial Artery ◽

Short Term ◽

Distal Radial Artery

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Reference diameter and characteristics of the distal radial artery based on ultrasonographic assessment

The Korean Journal of Internal Medicine ◽

10.3904/kjim.2020.685 ◽

2022 ◽

Vol 37 (1) ◽

pp. 109-118

Author(s):

Jun-Won Lee ◽

Jung-Woo Son ◽

Tae-Hwa Go ◽

Dae Ryong Kang ◽

Sang Jun Lee ◽

...

Keyword(s):

Coronary Angiography ◽

Radial Artery ◽

Limited Information ◽

Korean Patients ◽

Female Sex ◽

Low Body Mass Index ◽

Low Bmi ◽

The Right ◽

Diagnostic Coronary Angiography ◽

Distal Radial Artery

Background/Aims: While distal radial artery (DRA) access is increasingly being used for diagnostic coronary angiography, limited information is available regarding DRA size. We aimed to determine the DRA reference diameters of Korean patients and identify the predictors of DRA diameter < 2.3 mm.Methods: The outer bilateral DRA diameters were assessed using a linear ultrasound probe in 1,162 consecutive patients who underwent transthoracic echocardiography. The DRA diameter was measured by the perpendicular angle in the dorsum of the hand, and the average values were compared by sex. DRA diameter < 2.3 mm was defined as unsuitable for routine diagnostic coronary angiography using a 5 Fr introducer sheath.Results: The mean DRA diameters were 2.31 ± 0.43 mm (right) and 2.35 ± 0.45 mm (left). The DRA was smaller in women than men (right: 2.15 ± 0.38 mm vs. 2.43 ± 0.44 mm, p < 0.001; left: 2.18 ± 0.39 mm vs. 2.47 ± 0.45 mm, p < 0.001). The DRA diameter was approximately 20% smaller than the radial artery diameter. A total of 630 (54.2%) and 574 (49.4%) patients had DRA diameter < 2.3 mm in the right and left hands, respectively. Female sex, low body mass index (BMI), and low body surface area (BSA) were significant predictors of DRA diameter < 2.3 mm.Conclusions: We provided reference DRA diameters for Korean patients. Approximately 50% of the studied patients had DRA diameter < 2.3 mm. Female sex, low BMI, and low BSA remained significant predictors of DRA diameter < 2.3 mm.

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Randomized Comparison of Radiation Exposure in Coronary Angiography Between Right Conventional and Left Distal Radial Artery Approach

Case Medical Research ◽

10.31525/ct1-nct04023838 ◽

2019 ◽

Author(s):

Keyword(s):

Coronary Angiography ◽

Radiation Exposure ◽

Radial Artery ◽

Distal Radial Artery

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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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