Comparison of Distal Transradial Access in Anatomic Snuffbox Versus Transradial Access for Coronary Angiography

Authors

  • Hongjiang Lu Department of Cardiology, The 903 Hospital of PLA, Hangzhou 310013, China
  • Danning Wu Department of Cardiology, The 903 Hospital of PLA, Hangzhou 310013, China
  • Xiang Chen Department of Cardiology, The 903 Hospital of PLA, Hangzhou 310013, China

DOI:

https://doi.org/10.1532/hsf.3041

Keywords:

Distal radial artery, Percutaneous coronary angiography

Abstract

Background: To compare distal transradial access (dTRA) in the anatomic snuffbox and conventional transradial access (cTRA) for coronary angiography.

Methods: Eighty cases that underwent coronary angiography were selected at The 903 Hospital of PLA in China from April 2017 to March 2018. Patients in the dTRA group underwent distal transradial access, and patients in the cTRA group received conventional transradial access. Puncture success rate, fluoroscopy time, and hemostasis time were determined.

Results: The puncture success ratio was 85% in the dTRA group and 100% in the cTRA group (P < .05). The fluoroscopy time was 36 minutes and 19 min minutes in the dTRA group and cTRA group (P < .05), respectively. The compression hemostasis time after operation was 120 minutes and 240 minutes in the dTRA group and cTRA group (P < .05), respectively. The complication rate in the cTRA group was 7.5%, while there was no complication in the dTRA group. In addition, there also was no significant difference between the two groups in the rate of complications (cTRA = 7.5%, dTRA = 0.0%, P > .05).

Conclusion: Distal transradial access in the anatomical snuffbox for coronary angiogram is a potential alternative to conventional radial arterial access.

References

Agostoni P, Biondi-Zoccai GG, De Benedictis ML, et al. 2004. Radial versus femoral approach for percutaneous coronary diagnostic and interventional procedures: systematic overview and meta-analysis of randomized trials. Journal of the American College of Cardiology 44:349-56.

Amin R, Singha CK, Banerjee SK, et al. 2018. Comparison of Distal Transradial in the Anatomical Snuffbox versus Conventional Transradial Access for Coronary Angiography and Intervention-An Experience in 100 cases. University Heart Journal 13:40-5.

Bueno H, Bugiardini R, Carerj S, Casselman F. 2015. 2015 ESC guidelines for the management of acute coronary syndromes in patients presenting without persistent ST-segment elevation.

Jolly SS, Yusuf S, Cairns J, et al. 2011. Radial versus femoral access for coronary angiography and intervention in patients with acute coronary syndromes (RIVAL): a randomised, parallel group, multicentre trial. The Lancet 377:1409-20.

Kiemeneij F. 2017. Left distal transradial access in the anatomical snuffbox for coronary angiography (ldTRA) and interventions (ldTRI). EuroIntervention: journal of EuroPCR in collaboration with the Working Group on Interventional Cardiology of the European Society of Cardiology 13:851-7.

Kotowycz MA, Džavik V. 2012. Radial Artery Patency After Transradial Catheterization. Circulation-cardiovascular Interventions 5:127-33.

Nagai S, Abe S, Sato T, et al. 1999. Ultrasonic assessment of vascular complications in coronary angiography and angioplasty after transradial approach. American Journal of Cardiology 83:180-6.

Rao SV, O’Grady K, Pieper KS, et al. 2005. Impact of bleeding severity on clinical outcomes among patients with acute coronary syndromes. The American journal of cardiology 96:1200-6.

Stella PR, Kiemeneij F, Laarman G, Odekerken D, Slagboom T, Der Wieken RV. 1997. Incidence and outcome of radial artery occlusion following transradial artery coronary angioplasty. Catheterization and Cardiovascular Diagnosis 40:156-8.

Toledo J, Gubolino L, Teixeirense P, Bragalha Filho A. 2018. IJZ (2018) Diagnostic and Interventional Coronary Procedures by the Distal Radial Artery in the Anatomical SnuffBox: A Real World Analysis. J Cardiovasc Dis Diagn 6:2.

Valgimigli M, Gagnor A, Calabró P, et al. 2015. Radial versus femoral access in patients with acute coronary syndromes undergoing invasive management: a randomised multicentre trial. The Lancet 385:2465-76.

Zankl A, Andrassy M, Volz C, et al. 2010. Radial artery thrombosis following transradial coronary angiography: incidence and rationale for treatment of symptomatic patients with low-molecular-weight heparins. Clinical Research in Cardiology 99:841-7.

Published

2020-06-12

How to Cite

Lu, H. ., Wu, D. . ., & Chen, X. (2020). Comparison of Distal Transradial Access in Anatomic Snuffbox Versus Transradial Access for Coronary Angiography. The Heart Surgery Forum, 23(4), E407-E410. https://doi.org/10.1532/hsf.3041

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