Conventional transradial access versus distal transradial access for coronary angiography and interventions

Abstract

Introduction For so many years, femoral access has been the standard access for all interventional cardiologists performing coronary angiography and percutaneous coronary interventions. In the past 15 years, radial access gained more fame over femoral access as it has a lower risk of bleeding and it is more convenient to patients due to early mobilization and less hospital stay. Recently, the distal transradial access in the anatomical snuffbox has emerged as a new access for coronary procedures that carries some advantages over the standard proximal transradial access. These advantages include radial artery preservation in patients who may use radial artery graft for coronary bypass surgeries and those with end-stage renal disease who may use the radial artery for arterio-venous fistula. Aim The aim of this study is to compare the feasibility, safety, and complications of coronary angiography and intervention between distal transradial and conventional transradial access. Patients and methods This study was conducted between January 2019 and June 2020 on 100 patients who presented with chronic coronary syndrome previously known as stable angina to the outpatient clinic of our center who were scheduled for coronary angiography with possible coronary angioplasty if indicated. These patients were categorized into two groups, group A that consisted of 50 in which coronary angiography was done by conventional transradial route and group B that consisted of 50 in which coronary angiography was done by distal transradial route. Their demographic features and complications were recorded. Results Our results showed that patients who had their procedures through conventional radial access had more hematoma, bleeding, hand ischemia, and loss of radial artery than those who had their procedures done through distal transradial access. Conclusion From our results, we can conclude that distal transradial access in the anatomical snuffbox for coronary angiography and intervention is a better alternative, safe, and feasible option in comparison to conventional transradial access for both patients and operators.

Keywords

• coronary angiography
• distal radial access
• percutaneous coronary interventions
• radial access