Early prevention of radial artery occlusion via distal transradial access for primary percutaneous coronary intervention

Wang, Yujie; Liu, Zijing; Wu, Yongxia; Li, Zixuan; Wang, Yuntao; Wang, Senhu; Xu, Ran; Zhang, Libin; Wang, Yuping; Guo, Jincheng

doi:10.3389/fcvm.2022.1071575

Cited by 15 publications

(9 citation statements)

References 39 publications

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“…The complication rate of TRA group was 8.3%, which was significantly better than that of TFA. In 2021, the results of a Chinese study were consistent with ours, showing that the total complications of vascular puncture in SCCAG patients in the TRA group were less than those in the TFA group [2].…”

Section: Discussionsupporting

confidence: 70%

Effects of different puncture approaches on the curative effect and safety of patients with combined cardiovascular and cerebrovascular angiography

Xi,

Lu,

Wang

et al. 2023

Videosurgery and Other Miniinvasive Techniques

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Introduction:The relationship between different puncture points and perioperative complications and length of stay in hospital (LOS) in SCCAG patients has rarely been reported. Aim: To compare the curative effect and safety of the transradial artery approach and the transfemoral artery approach in combined heart-brain angiography. Material and methods: 120 patients who received combined cardio-cerebral angiography in our hospital were selected and divided into a transradial artery approach group (TRA) and a transfemoral artery approach group (TFA) according to a random number table. The postoperative efficacy and safety of the 2 groups were compared. Results: There was no statistically significant difference in puncture time and operation time between the 2 groups (p > 0.05). Postoperative bed rest time, hospitalization time, and X-ray exposure time in the TRA group were shorter than those in the TFA group, and the difference was statistically significant (p < 0.05). Before operation and 3 days after operation, there was no significant difference in left ventricle ejection fraction between the 2 groups (p > 0. 05). The overall incidence of complications in the TFA group was higher than that in the TRA group. The incidence between haematoma and pseudoaneurysm in the TFA group was higher, and the difference was statistically significant (p < 0.05). Conclusions: For simultaneous heart-brain angiography, interventional therapy via radial artery and femoral artery has good curative effect and can improve cardiac function. However, interventional therapy through the radial artery can shorten the postoperative bed rest time and hospitalization time, and reduce the incidence of complications.

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Section: Discussionsupporting

confidence: 70%

Effects of different puncture approaches on the curative effect and safety of patients with combined cardiovascular and cerebrovascular angiography

Xi,

Lu,

Wang

et al. 2023

Videosurgery and Other Miniinvasive Techniques

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“…A prospective clinical trial performed by Andrea Pacchioni et al reported that the RAO incidence in DRA was 0.5%, which was much lower than that in CRA (0.5% vs. 4.8%, p < 0.01) [ 24 ]. A dramatic reduction in RAO after dTRA was observed in the study of Eid-Lidt et al [ 25 ] and YJ Wang et al [ 19 ]. A recent meta- analysis showed that dTRA was associated with a significant lower risk of RAO (risk ratio [RR]: 0.36; 95% CI:0.23-0.56; p < 0.001) in comparison to cTRA [ 26 ].…”

Section: Discussionmentioning

confidence: 91%

“…Kim Y reported that the mean snuffbox puncture time was 2.7 ± 1.6 min in patients with STEMI, which did not delay the D-to-B time [ 16 ]. YJ Wang showed that puncture time in the dTRA group was longer than that in the cTRA group [2.4 (1.7–4.2) min vs. 1.7 (1.4–2.3) min; p < 0.001) whereas the door-to-wire time was not delayed in patients with STEMI [71 (54–88) min vs. 64 (56–82) min, p = 0.103] [ 19 ]. Similarly, our study showed that the dTRA puncture time was 2 (1, 3) min, and no significant differences were observed in D-to-B time [65 (65, 75) min vs. 65 (40, 80) min, p > 0.05] between the dTRA group and the cTRA group.…”

Section: Discussionmentioning

confidence: 99%

Comparison of the feasibility and safety between distal transradial access and conventional transradial access in patients with acute chest pain: a single-center cohort study using propensity score matching

Liang

et al. 2023

BMC Geriatr

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Background Distal transradial access (dTRA) has been suggested to have great advantages over cTRA. However, there is a lack of preliminary data on dTRA in patients undergoing emergency coronary angiography (CAG) or percutaneous coronary intervention (PCI). To explore the feasibility and safety of distal transradial access in patients with acute chest pain. Methods A total of 1269 patients complaining of acute chest pain in our emergency department from January 2020 to February 2022 were retrospectively included. The patients who met the inclusion criteria were divided into the conventional transradial access (cTRA) group (n = 238) and the dTRA group (n = 158). Propensity score matching was used to minimize the baseline differences. Results The cannulation success rate in the dTRA group was significantly lower than that in the cTRA group (87.41% vs. 94.81%, p < 0.05). No significant differences in the puncture time and total procedure time were noted between the two groups (p > 0.05). Compared with the cTRA group, the hemostasis duration was significantly shorter [4(4, 4) h vs. 10(8, 10) h, p < 0.001) and the incidence of minor bleeding (BARC Type I and II) was significantly lower in the dTRA group than that in the cTRA group (0.85% vs. 5.48%, p = 0.045). Asymptomatic radial artery occlusion was observed in six patients (5.83%) in the cTRA group and one patient (1.14%) in the dTRA group (p = 0.126). The subgroup analysis of ST-elevation myocardial infarction (STEMI) showed no significant differences in the puncture time, D-to-B time or total procedure time between the two groups. Conclusions The dTRA for emergency CAG or PCI has an acceptable success rate and puncture time, a shorter hemostasis time, and a downward trend in RAO rate compared to the cTRA. The dTRA did not increase the D-to-B time in emergency coronary interventions in STEMI patients. On the contrary, a low incidence of RAO by the dTRA created an opportunity for future coronary interventions in non-culprit vessels in the same access. Trial registration Retrospectively registered in Chinese Clinical Trial Registry (registry number: ChiCTR2200061104, date of registration: June 15, 2022).

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“…Clinical studies have shown that dTRA, compared with TRA, significantly decreases the incidence of RAO 24 hours and 30 days after coronary operation. Subgroup analysis has suggested that dTRA is feasible for PCI of single-vessel, double-vessel, and left main coronary artery disease, and that dTRA is also feasible for coronary artery disease intervention [2,[7][8][9][10]. Although some retrospective studies have been conducted, the safety and effectiveness of dTRA for coronary artery disease intervention in China have not been further confirmed in randomized controlled trials.…”

Section: Introductionmentioning

confidence: 99%

Protocol for a Single-Center Randomized Controlled Trial of Percutaneous Coronary Intervention Via Distal Transradial Access Versus Transradial Access

Liu,

Wang,

Gao

et al. 2024

CVIA

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Background: Although transradial access (TRA) has become the main vascular access for coronary intervention, its high radial artery occlusion rate limits its application in some patients. Studies have shown that compared with TRA, distal transradial access (dTRA) with the snuffbox area or the Hegu acupoint area as the puncture point significantly decreases the incidence of radial artery occlusion. However, no randomized controlled study has confirmed the safety and efficacy of coronary artery intervention via dTRA in China. Methods and analyses: This single-center, prospective, randomized controlled, superiority open-label study will enroll 428 consecutive patients with coronary heart disease undergoing percutaneous coronary intervention as the study population. After preoperative evaluation, the participants will be randomly divided into a study group (dTRA) and control group (TRA) in a 1:1 ratio. The primary endpoint (radial artery occlusion at 24 hours after operation) and secondary endpoint events will be evaluated and recorded. Study registration: This study has been registered in the Chinese Clinical Trial Registry (registration number: ChiCTR2300073902).

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Early prevention of radial artery occlusion via distal transradial access for primary percutaneous coronary intervention

Cited by 15 publications

References 39 publications

Effects of different puncture approaches on the curative effect and safety of patients with combined cardiovascular and cerebrovascular angiography

Effects of different puncture approaches on the curative effect and safety of patients with combined cardiovascular and cerebrovascular angiography

Comparison of the feasibility and safety between distal transradial access and conventional transradial access in patients with acute chest pain: a single-center cohort study using propensity score matching

Protocol for a Single-Center Randomized Controlled Trial of Percutaneous Coronary Intervention Via Distal Transradial Access Versus Transradial Access

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