Coronary disease & ACSCohort study

Distal Radial Access for Coronary Procedures in a Large Prospective Multicenter Registry

JACC Cardiovasc IntervPublished

  • Prospective multicentre registry
  • 14 hospitals

Authors' conclusion

In this large-scale prospective multicenter registry, DRA demonstrated high success rates of CAG and PCI, with a high rate of puncture success but low rates of distal radial artery occlusion, radial artery occlusion, bleeding events, and procedure-related complications. Weak pulse and DRA experience <100 cases were predictors of puncture failure.

Study context

Population
Patients undergoing coronary angiography or percutaneous coronary intervention (PCI) via distal radial access, 14 Korean hospitals, September 2019 – September 20215,712 screened
Participants
4,977 patients
Outcome
Success rates of coronary angiography (CAG) and PCI

Main finding

As reported in the abstract

Procedural success via DRA
GroupCoronary angiography (CAG) successPCI success
Distal radial access (DRA)100%98.8%

Observational data: associations, not effects.

Secondary outcomes

Predictors of puncture failure (multilevel logistic regression)

ComparisonOR (95% CI)
Weak pulse9.994 (7.252–13.774)
DRA experience <100 cases2.187 (1.383–3.456)

Successful distal radial artery puncture

Puncture success
94.4%

Access-site crossover

Access-site crossover, 333 patients
6.7%

Safety

OutcomeValues
Distal radial artery occlusion and radial artery occlusion (by palpation) · 1-month follow-upDRA Distal radial artery occlusion 0.8% (36 of 4,340) · Radial artery occlusion 0.8% (33 of 4,340)
DRA-related bleeding eventsDRA 3.3%

DRA-related bleeding events

No serious hematoma

Original publication

Distal Radial Access for Coronary Procedures in a Large Prospective Multicenter Registry. JACC Cardiovasc Interv. Published 12 February 2024. doi:10.1016/j.jcin.2023.11.021

Summarised from the published abstract; every number is checked against it