Scholarlink

Background <p>Transradial access (TRA) is recommended as the primary route for coronary angiography (CAG) and percutaneous coronary intervention (PCI). In recent years, a more distal puncture site in the area of the anatomical snuffbox (distal radial access; dRA) has been established. In this randomized multicenter trial, we aim to demonstrate the superiority of dRA with respect to the rate of radial artery occlusion (RAO) compared with the traditional proximal radial access (pRA).</p> Methods <p>Patients scheduled for CAG or PCI in five cardiology centers in Germany were randomized for standard pRA or dRA. The primary endpoint was a reduced rate of RAO (superiority) after 30&#xa0;days. Secondary endpoints included crossover rate, hand function assessed by QuickDASH test, duration of the puncture and procedure, and the puncture success rate. Proximal and distal radial artery patency was examined by ultrasound within 48&#xa0;h and after 30&#xa0;days.</p> Results <p>A total of 254 patients were enrolled (mean age: 66 ± 10&#xa0;years, 71% male gender, 48% PCI). The trial was halted prematurely after 50% of the planned population. The primary endpoint was numerically reduced in the dRA group (<i>N</i> = 1/128; 0.9%) compared with the pRA group (<i>N</i> = 3/126, 2.8%), but the difference was not statistically significant (<i>P</i> = 0.36). Puncture success was high in both arms (<i>N</i> = 240/254, 94%) and no statistically significant difference between the two puncture sites (dRA: 91%; pRA: 98%) was observed. Major complications were not encountered.</p> Conclusion <p>The rate of radial artery occlusion after dRA for coronary intervention was not significantly reduced compared with pRA.</p> Trial registration <p>This study is registered in ClinicalTrials: NCT04194606.</p> Graphical Abstract <p></p>

错误：搜索内容不能为空，请输入英文关键词
错误：关键词超出字数限制，请精简
高级检索

CORRECT RADIAL RCT. CORonaRy angiography and intErventions via distal vs proximal transradial aCcess—a randomized Trial of different RADIAL puncture sites

  • 期刊论文

  • 出版模式：

    开放获取

  • 发表日期：

    2025年11月24日

查看全文
  • Karsten Schenke,
  • Rostislav Prog,
  • Nader Joghetaei,
  • Nitin Sood,
  • Achim Viertel,
  • Timm Matthiesen,
  • Lorenz Bott-Flügel,
  • Simon Ohm,
  • Thorsten Dill,
  • Gerian Grönefeld

摘要

Background

Transradial access (TRA) is recommended as the primary route for coronary angiography (CAG) and percutaneous coronary intervention (PCI). In recent years, a more distal puncture site in the area of the anatomical snuffbox (distal radial access; dRA) has been established. In this randomized multicenter trial, we aim to demonstrate the superiority of dRA with respect to the rate of radial artery occlusion (RAO) compared with the traditional proximal radial access (pRA).

Methods

Patients scheduled for CAG or PCI in five cardiology centers in Germany were randomized for standard pRA or dRA. The primary endpoint was a reduced rate of RAO (superiority) after 30 days. Secondary endpoints included crossover rate, hand function assessed by QuickDASH test, duration of the puncture and procedure, and the puncture success rate. Proximal and distal radial artery patency was examined by ultrasound within 48 h and after 30 days.

Results

A total of 254 patients were enrolled (mean age: 66 ± 10 years, 71% male gender, 48% PCI). The trial was halted prematurely after 50% of the planned population. The primary endpoint was numerically reduced in the dRA group (N = 1/128; 0.9%) compared with the pRA group (N = 3/126, 2.8%), but the difference was not statistically significant (P = 0.36). Puncture success was high in both arms (N = 240/254, 94%) and no statistically significant difference between the two puncture sites (dRA: 91%; pRA: 98%) was observed. Major complications were not encountered.

Conclusion

The rate of radial artery occlusion after dRA for coronary intervention was not significantly reduced compared with pRA.

Trial registration

This study is registered in ClinicalTrials: NCT04194606.

Graphical Abstract