Distal radial access (DRA) has emerged as a promising refinement of conventional transradial access (TRA) in interventional cardiology. While TRA was introduced in the 1990s as a safer alternative to transfemoral access (TFA), it presented challenges including a steep learning curve and the risk of radial artery occlusion (RAO). Though more technically demanding, DRA offers significant potential benefits, including reduced risk of RAO, improved patient and operator comfort, and improved cost-effectiveness. The transition from TRA to DRA faces adoption hurdles reminiscent of the early days of TRA. Nevertheless, DRA success rates typically exceed 90%, with the option to convert to conventional TRA if necessary. Adoption is accelerating, facilitated by the rapid dissemination of information via social media and the growing practitioner experience. In particular, interventional radiologists and neurointerventionalists have shown particular interest, often adopting DRA directly as an alternative to TFA. This rapid proliferation of DRA-related information has fostered a cycle of continuous improvement, driving expertise and innovation in the field. Controversy may arise due to contentious scientific evidence, but proponents argue that the potential patient benefits justify further exploration and implementation of this novel approach.

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Introduction

  • Ferdinand Kiemeneij

摘要

Distal radial access (DRA) has emerged as a promising refinement of conventional transradial access (TRA) in interventional cardiology. While TRA was introduced in the 1990s as a safer alternative to transfemoral access (TFA), it presented challenges including a steep learning curve and the risk of radial artery occlusion (RAO). Though more technically demanding, DRA offers significant potential benefits, including reduced risk of RAO, improved patient and operator comfort, and improved cost-effectiveness. The transition from TRA to DRA faces adoption hurdles reminiscent of the early days of TRA. Nevertheless, DRA success rates typically exceed 90%, with the option to convert to conventional TRA if necessary. Adoption is accelerating, facilitated by the rapid dissemination of information via social media and the growing practitioner experience. In particular, interventional radiologists and neurointerventionalists have shown particular interest, often adopting DRA directly as an alternative to TFA. This rapid proliferation of DRA-related information has fostered a cycle of continuous improvement, driving expertise and innovation in the field. Controversy may arise due to contentious scientific evidence, but proponents argue that the potential patient benefits justify further exploration and implementation of this novel approach.