Distal Radial Access for Coronary Procedures in a Large Prospective Multicenter Registry: The KODRA Trial
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
Methodological details14 hospitals
- 14 hospitals
Main finding
As reported in the abstract
Procedural success via DRA
| Group | Coronary angiography (CAG) success | PCI success |
|---|---|---|
| Distal radial access (DRA) | 100% | 98.8% |
Distal radial access (DRA)
Coronary angiography (CAG) success100%
PCI success98.8%
Observational data: associations, not effects.
Secondary outcomes
Predictors of puncture failure (multilevel logistic regression)
| Comparison | OR (95% CI) | |
|---|---|---|
| Weak pulse | 9.994 (7.252–13.774) | |
| DRA experience <100 cases | 2.187 (1.383–3.456) | |
| 0.050.21520Odds ratio (log scale) |
Successful distal radial artery puncture
- Puncture success
- 94.4%
Access-site crossover
- Access-site crossover, 333 patients
- 6.7%
Safety
| Outcome | Values |
|---|---|
| Distal radial artery occlusion and radial artery occlusion (by palpation) · 1-month follow-up | DRA Distal radial artery occlusion 0.8% (36 of 4,340) · Radial artery occlusion 0.8% (33 of 4,340) |
| DRA-related bleeding events | DRA 3.3% |
DRA-related bleeding events
- No serious hematoma
Original publication
Distal Radial Access for Coronary Procedures in a Large Prospective Multicenter Registry: The KODRA Trial. JACC Cardiovasc Interv. Published 12 February 2024. doi:10.
Summarised from the published abstract; every number is checked against it