Distal Radial Artery Access Among Cases With Radial Artery Occlusion for Primary Percutaneous Intervention

Alkhawam, Hassan; Windish, Stephanie; Abo-Salem, Elsayed

doi:10.2217/fca-2018-0057

Cited by 15 publications

(14 citation statements)

References 20 publications

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“…For example, in elderly people with arthrosis and deformities of the hand probably cTRA should be preferred. 23 As the experience with such approach increases, other potential fields of application are rising, including patients with occluded radial artery, 24 carotid, 25 femoral, and in general endovascular extracardiac interventions. 26,27 Large scale randomized trials comparing right/left cTRA and left dTRA in terms of patients' comfort, immediate outcomes, and cost/benefit balance are claimed before a wide acceptance of this promising approach.…”

Section: Discussionmentioning

confidence: 99%

Distal snuffbox versus conventional radial artery access: An updated systematic review and meta-analysis

et al. 2021

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Background: A comprehensive comparison of available data in terms of vascular complications between distal and conventional transradial access is still partial and a net benefit of such approach has not yet been clearly demonstrated. Objective: To provide an updated comparison of complications between distal and conventional transradial access used to perform coronary angiography and/or percutaneous coronary intervention performing a systematic review and meta-analysis. Data sources: Data were obtained searching MEDLINE, Scopus, and Web of Science for all investigations published any time to December 22, 2020 reporting a comparison between distal and conventional transradial access. The occurrence of radial artery occlusion was chosen as the primary outcome while the hematoma at access site and spasm as secondary and tertiary outcome, respectively. Study eligibility criteria: Case-control studies comparing distal and conventional transradial access for coronary angiography and/or percutaneous coronary intervention. All studies included adult patients aged at least 18 years. Study appraisal and synthesis methods: Overall, 7073 patients (mean age 57.9 and 58.4 years for distal and conventional transradial access, respectively), were analyzed. The rate of radial artery occlusion was significantly lower in the distal compared with the conventional group (2.1% vs 4.6%, p < 0.001). The pooled analysis, based on a fixed effect model confirmed a lower relative risk of occlusion when distal access is used (RR: 0.46, 95% CI: 0.31–069, p = 0.002, I2 = 0%). Conversely, no differences in the risk of developing a hematoma at the access site or in the occurrence of a radial artery spasms were observed comparing the two groups (RR: 0.65, 95% CI: 0.37–1.13, p = 0.12, I2 = 0% and RR: 0.88, 95% CI: 0.48–1.63, p = 0.001, I2 = 0%, respectively). Limitations: Only eight case-control studies met inclusion criteria Conclusion: This metanalysis confirmed a lower risk of radial artery occlusion using distal access and comparable performance in terms of hematoma, and radial artery spam risk.

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Section: Discussionmentioning

confidence: 99%

Distal snuffbox versus conventional radial artery access: An updated systematic review and meta-analysis

et al. 2021

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“…Other advantages include early hemostasis, low risk for hematoma formation, low level of pain perceived by patients, reduced risk of compartment syndrome, saving the radial artery for possible future coronary artery bypass graft, and the ability of the operator to work at a safe distance from the radiation source [5,13,22,31]. Finally, it might be a potential site for retrograde recanalization of RAO [32].…”

Section: Advantagementioning

confidence: 99%

Distal Radial Artery Access: The Future of Cardiovascular Intervention

Nairoukh¹,

Jahangir²,

Adjepong³

et al. 2020

Cureus

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Access sites for coronary intervention have been changing over the last several decades, from the femoral artery to the radial artery and then to the distal radial artery. Distal radial access, which was first used in 2017 and is still not recommended by the guidelines, shows a higher success rate and less complications than other sites; therefore, it might be the future for cardiovascular intervention. In this study, we reviewed almost all of the articles that are related to the distal radial access, from 2017 to present, and summarized the technique, success rate, advantages, disadvantages, and noncardiac use of this access site.

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“…In recent years, the distal transradial approach (dTRA), as an alternative approach for cardiac catheterization, has gradually become familiar to cardiologic interventionalists. In the past 2 years, an increasing number of studies have focused on the feasibility and safety of the dTRA approach for coronary angiography (CAG) and percutaneous coronary intervention (PCI) in different countries [7][8][9][10][11][12][13][14][15]. However, as a new approach, it also has some disadvantages.…”

Section: Introductionmentioning

confidence: 99%

Distal transradial access: a review of the feasibility and safety in cardiovascular angiography and intervention

Cai

Huang

Feng

et al. 2020

BMC Cardiovasc Disord

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Background: Transradial access (TRA) has been considered as the default choice in cardiac catheterization. Although infrequent, vascular complications of this approach remain. Recently, the distal transradial approach (dTRA) in cardiac catheterization was reported by interventionalists. Methods: We retrieved the relevant literatures and reviewed the safety and feasibility of this novel approach in cardiac catheterization. Results: The dTRA for cardiac intervention has superior safety and satisfaction. As a novel approach for cardiac catheterization, access related complications should also be considered by operators, such as RAO, radial spasm, bleeding and haematoma, and injury of the superficial branch of the radial nerve. Conclusions: The dTRA in cardiovascular angiography and intervention was safe and feasible.

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Distal Radial Artery Access Among Cases With Radial Artery Occlusion for Primary Percutaneous Intervention

Cited by 15 publications

References 20 publications

Distal snuffbox versus conventional radial artery access: An updated systematic review and meta-analysis

Distal snuffbox versus conventional radial artery access: An updated systematic review and meta-analysis

Distal Radial Artery Access: The Future of Cardiovascular Intervention

Distal transradial access: a review of the feasibility and safety in cardiovascular angiography and intervention

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