Rationale and Design of the Rivaroxaban Post-Transradial Access for the Prevention of Radial Artery Occlusion Trial (CAPITAL-RAPTOR)

Abstract

IntroductionTransradial access (TRA) has rapidly emerged as the preferred vascular access site for coronary angiography and percutaneous coronary intervention. Radial artery occlusion (RAO) remains as an important complication of TRA as it precludes future ipsilateral transradial procedures. While intraprocedural anticoagulation has been studied extensively, the definitive role of postprocedural anticoagulation has not yet been established.Methods and analysisThe Rivaroxaban Post-Transradial Access for the Prevention of Radial Artery Occlusion trial is a multicentre, prospective, randomised, open-label, blinded-endpoint design study investigating the efficacy and safety of rivaroxaban to reduce the incidence of RAO. Eligible patients will undergo randomisation to receive either rivaroxaban 15 mg once daily for 7 days or to no additional postprocedural anticoagulation. Doppler ultrasound to assess radial artery patency will be performed at 30 days.Ethics and disseminationThe study protocol has been approved by the Ottawa Health Science Network Research Ethics Board (approval number 20180319-01H). The study results will be disseminated via conference presentations and peer-reviewed publications.Trial registration numberNCT03630055.

Distinct pleiotropic effects of direct oral anticoagulants on cultured endothelial cells: a comprehensive review

“…Specifically, studies in rodents have suggested that DOACs exert pleiotropic effects on ECs through PAR mediation confirming their existence ( Lee et al, 2012 ; Pingel et al, 2014 ; Villari et al, 2017 ; Rahadian et al, 2020 ; Ito et al, 2021 ). Furthermore, ongoing investigations in clinical settings ( Di Santo et al, 2023 ) have shed additional light on the pleiotropic effects of DOACs, and evidence has already emerged from clinical studies, indicating that DOACs improve cardiovascular health beyond their primary anticoagulant function ( Pistrosch et al, 2021 ; Lin et al, 2023 ).…”