Coronary Angiogram using Distal Radial Access: A Retrospective Observational Study

Abstract

Introduction: Transradial access has become gold standard for percutaneous coronary catheterisation procedures. As the learning curve overcomes, safe alternative access sites such as Distal Radial Artery (DRA), ulnar artery have been tried. Aim: The aim of this study was to generate best evidence for using right DRA for coronary angiography. Materials and Methods: In this retrospective study, a novel route in addition to radial artery was studied. A total of 150 cases who underwent the angiogram by the DRA technique were included in the study, preserving the radial artery for various procedures. DRA was punctured in anatomical snuffbox by standard techniques and coronary angiography was performed. The evaluated parameters included the characteristics of patients (gender and age distribution), blood pressure (systolic and diastolic), mean arterial pressure, flouro time, puncture time, Dose Area Product (DAP) and cumulative air kerma. Fisher’s-exact test was used to find out the association between the gender, hypertension, diabetes and the success of puncture. Results: There was 93.4% successful puncture rate for distal radial access. There was no influence of age on the success of puncture. The association of success of puncture with gender, hypertension and diabetes was not statistically significant. Conclusion: This study presents that the distal radial approach is feasible and relatively safe. Further randomised controlled trials may be required to establish this relatively new approach as the standard care.

Keywords

• anatomical snuffbox
• coronary angiography
• distal radial artery