Distal radial access for coronary procedures in an all-comer population: the first 1000 patients in a prospective cohort
ABSTRACT Introduction and objectives: Distal radial access (DRA) for coronary procedures is currently recognized as an alternative to conventional transradial access, with documented advantages primarily related to access-related complications. However, widespread adoption of DRA as the default appr...
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2024-11-01
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| Series: | REC: Interventional Cardiology (English Ed.) |
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| author | Kristian Rivera Diego Fernández-Rodríguez Marcos García-Guimarães Juan Casanova-Sandoval Patricia Irigaray Marta Zielonka Tania Ramírez Martínez David Arroyo-Calpe Joan Costa-Mateu María Tornel-Cerezo Anna Baiget-Pons Oriol Roig-Boira Eduard Perelló-Cortí Xenia Castillo-Peña Raquel Royo-Beltrán Fernando Worner José Luis Ferreiro |
| author_facet | Kristian Rivera Diego Fernández-Rodríguez Marcos García-Guimarães Juan Casanova-Sandoval Patricia Irigaray Marta Zielonka Tania Ramírez Martínez David Arroyo-Calpe Joan Costa-Mateu María Tornel-Cerezo Anna Baiget-Pons Oriol Roig-Boira Eduard Perelló-Cortí Xenia Castillo-Peña Raquel Royo-Beltrán Fernando Worner José Luis Ferreiro |
| author_sort | Kristian Rivera |
| collection | DOAJ |
| description | ABSTRACT Introduction and objectives: Distal radial access (DRA) for coronary procedures is currently recognized as an alternative to conventional transradial access, with documented advantages primarily related to access-related complications. However, widespread adoption of DRA as the default approach remains limited. Therefore, this prospective cohort study aimed to present our initial experience with DRA for coronary procedures in any clinical settings. Methods: From August 2020 to November 2023, we included 1000 DRA procedures (943 patients) conducted at a single center. The study enrolled a diverse patient population. We recommended pre- and postprocedural ultrasound evaluations of the radial artery course, with ultrasound-guided DRA puncture. The primary endpoint was DRA success, while secondary endpoints included coronary procedure success, DRA performance metrics, and the incidence of access-related complications. Results: The DRA success rate was 97.4% (n = 974), with coronary procedure success at 96.9% (n = 969). The median DRA time was 40 [interquartile range, 30-60] seconds. Diagnostic procedures accounted for 64% (n = 644) of cases, while 36% (n = 356) involved percutaneous coronary intervention (PCI), including primary PCI in 13% (n = 128). Pre-procedure ultrasound evaluation and ultrasound-guided DRA were performed in 83% (n = 830) and 85% (n = 848) of cases, respectively. Access-related complications occurred in 2.9% (n = 29). Conclusions: This study shows the safety and feasibility of DRA for coronary procedures, particularly when performed under ultrasound guidance in a diverse patient population. High rates of successful access and coronary procedure outcomes were observed, together with a low incidence of access-related complications. The study was registered on ClinicalTrials.gov (NTC06165406). |
| format | Article |
| id | doaj-art-0f0b15575d3d475f970fba0252070447 |
| institution | Kabale University |
| issn | 2604-7322 |
| language | English |
| publishDate | 2024-11-01 |
| publisher | Permanyer |
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| series | REC: Interventional Cardiology (English Ed.) |
| spelling | doaj-art-0f0b15575d3d475f970fba02520704472024-11-13T17:23:09ZengPermanyerREC: Interventional Cardiology (English Ed.)2604-73222024-11-016428729510.24875/RECICE.M24000470Distal radial access for coronary procedures in an all-comer population: the first 1000 patients in a prospective cohortKristian Rivera0Diego Fernández-Rodríguez1Marcos García-Guimarães2Juan Casanova-Sandoval3Patricia Irigaray4Marta Zielonka5Tania Ramírez Martínez6David Arroyo-Calpe7Joan Costa-Mateu8María Tornel-Cerezo9Anna Baiget-Pons10Oriol Roig-Boira11Eduard Perelló-Cortí12Xenia Castillo-Peña13Raquel Royo-Beltrán14Fernando Worner15José Luis Ferreiro16Servei de Cardiologia, Hospital Universitari Arnau de Vilanova, Lleida, Spain. Grup de Fisiologia i Patologia Cardíaca, Institut de Recerca Biomèdica de Lleida Fundació Dr. Pifarré, IRBLleida, Lleida, SpainServei de Cardiologia, Hospital Universitari Arnau de Vilanova, Lleida, Spain. Grup de Fisiologia i Patologia Cardíaca, Institut de Recerca Biomèdica de Lleida Fundació Dr. Pifarré, IRBLleida, Lleida, SpainServei de Cardiologia, Hospital Universitari Arnau de Vilanova, Lleida, Spain. Grup de Fisiologia i Patologia Cardíaca, Institut de Recerca Biomèdica de Lleida Fundació Dr. Pifarré, IRBLleida, Lleida, SpainServei de Cardiologia, Hospital Universitari Arnau de Vilanova, Lleida, Spain. Grup de Fisiologia i Patologia Cardíaca, Institut de Recerca Biomèdica de Lleida Fundació Dr. Pifarré, IRBLleida, Lleida, SpainServei de Cardiologia, Hospital Universitari Arnau de Vilanova, Lleida, Spain. Grup de Fisiologia i Patologia Cardíaca, Institut de Recerca Biomèdica de Lleida Fundació Dr. Pifarré, IRBLleida, Lleida, SpainServei de Cardiologia, Hospital Universitari Arnau de Vilanova, Lleida, Spain. Grup de Fisiologia i Patologia Cardíaca, Institut de Recerca Biomèdica de Lleida Fundació Dr. Pifarré, IRBLleida, Lleida, SpainServei de Cardiologia, Hospital Universitari Arnau de Vilanova, Lleida, Spain. Grup de Fisiologia i Patologia Cardíaca, Institut de Recerca Biomèdica de Lleida Fundació Dr. Pifarré, IRBLleida, Lleida, SpainServei de Cardiologia, Hospital Universitari Arnau de Vilanova, Lleida, SpainServei de Cardiologia, Hospital Universitari Arnau de Vilanova, Lleida, SpainServei de Cardiologia, Hospital Universitari Arnau de Vilanova, Lleida, SpainServei de Cardiologia, Hospital Universitari Arnau de Vilanova, Lleida, SpainServei de Cardiologia, Hospital Universitari Arnau de Vilanova, Lleida, SpainServei de Cardiologia, Hospital Universitari Arnau de Vilanova, Lleida, SpainServei de Cardiologia, Hospital Universitari Arnau de Vilanova, Lleida, SpainServei de Cardiologia, Hospital Universitari Arnau de Vilanova, Lleida, SpainServei de Cardiologia, Hospital Universitari Arnau de Vilanova, Lleida, Spain. Grup de Fisiologia i Patologia Cardíaca, Institut de Recerca Biomèdica de Lleida Fundació Dr. Pifarré, IRBLleida, Lleida, SpainServei de Cardiologia, Hospital Universitari Joan XXIII, Institut d Investigació Sanitària Pere Virgili (IISPV), Tarragona, Spain. Centro de Investigación Biomédica en Red de Enfermedades Cardiovasculares (CIBERCV), SpainABSTRACT Introduction and objectives: Distal radial access (DRA) for coronary procedures is currently recognized as an alternative to conventional transradial access, with documented advantages primarily related to access-related complications. However, widespread adoption of DRA as the default approach remains limited. Therefore, this prospective cohort study aimed to present our initial experience with DRA for coronary procedures in any clinical settings. Methods: From August 2020 to November 2023, we included 1000 DRA procedures (943 patients) conducted at a single center. The study enrolled a diverse patient population. We recommended pre- and postprocedural ultrasound evaluations of the radial artery course, with ultrasound-guided DRA puncture. The primary endpoint was DRA success, while secondary endpoints included coronary procedure success, DRA performance metrics, and the incidence of access-related complications. Results: The DRA success rate was 97.4% (n = 974), with coronary procedure success at 96.9% (n = 969). The median DRA time was 40 [interquartile range, 30-60] seconds. Diagnostic procedures accounted for 64% (n = 644) of cases, while 36% (n = 356) involved percutaneous coronary intervention (PCI), including primary PCI in 13% (n = 128). Pre-procedure ultrasound evaluation and ultrasound-guided DRA were performed in 83% (n = 830) and 85% (n = 848) of cases, respectively. Access-related complications occurred in 2.9% (n = 29). Conclusions: This study shows the safety and feasibility of DRA for coronary procedures, particularly when performed under ultrasound guidance in a diverse patient population. High rates of successful access and coronary procedure outcomes were observed, together with a low incidence of access-related complications. The study was registered on ClinicalTrials.gov (NTC06165406).https://recintervcardiol.org/en/index.php?option=com_content&view=article&id=1333Vascular access Distal radial artery Coronary angiography Percutaneous transluminal coronary angioplasty Doppler ultrasound Access-related complications |
| spellingShingle | Kristian Rivera Diego Fernández-Rodríguez Marcos García-Guimarães Juan Casanova-Sandoval Patricia Irigaray Marta Zielonka Tania Ramírez Martínez David Arroyo-Calpe Joan Costa-Mateu María Tornel-Cerezo Anna Baiget-Pons Oriol Roig-Boira Eduard Perelló-Cortí Xenia Castillo-Peña Raquel Royo-Beltrán Fernando Worner José Luis Ferreiro Distal radial access for coronary procedures in an all-comer population: the first 1000 patients in a prospective cohort REC: Interventional Cardiology (English Ed.) Vascular access Distal radial artery Coronary angiography Percutaneous transluminal coronary angioplasty Doppler ultrasound Access-related complications |
| title | Distal radial access for coronary procedures in an all-comer population: the first 1000 patients in a prospective cohort |
| title_full | Distal radial access for coronary procedures in an all-comer population: the first 1000 patients in a prospective cohort |
| title_fullStr | Distal radial access for coronary procedures in an all-comer population: the first 1000 patients in a prospective cohort |
| title_full_unstemmed | Distal radial access for coronary procedures in an all-comer population: the first 1000 patients in a prospective cohort |
| title_short | Distal radial access for coronary procedures in an all-comer population: the first 1000 patients in a prospective cohort |
| title_sort | distal radial access for coronary procedures in an all comer population the first 1000 patients in a prospective cohort |
| topic | Vascular access Distal radial artery Coronary angiography Percutaneous transluminal coronary angioplasty Doppler ultrasound Access-related complications |
| url | https://recintervcardiol.org/en/index.php?option=com_content&view=article&id=1333 |
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