The L eft D i stal t ransradial a ccess site co u ld give a safe alter n ate sit e for tra n sradial coronary in t ervention (The Litaunent Study).
Emrah AcarServet IzciIbrahim DonmezMehmet Fatih YılmazNeryan OzgulOguz KayabasıMustafa GokceYilmaz GüneşIbrahim Akin IzgiCevat KirmaPublished in: Angiology (2023)
Transradial Access (TRA) is the suggested method when performing coronary procedures. TRA has several advantages over the transfemoral approach, but also some restrictions. The present study compared the efficacy and safety of the traditional proximal transradial approach (pTRA) with a newer technique known as the distal transradial approach (dTRA) for performing a coronary angiography (CAG) and percutaneous coronary intervention (PCI). Patients (n = 700) were placed into one of two categories (dTRA or pTRA) based on a random technique. The primary endpoint was RAO at follow-up. The secondary endpoints included the time required for sheath insertion, the rate of successful sheath insertion, rate of successful completion of CAG and PCI, total procedure time, total fluoroscopy time, total radiation dose, total contrast volume used, pain perception (visual analog scale 0-10), and hemostasis duration. dTRA patients had more skin punctures, failed punctures, failed wiring, overlap of access sites, sheath insertion time, and pain evaluation scale, while the pTRA group had more hemostasis time and first-time cannulation. RAO and pseudoaneurysm (PseA) were lower in the dTRA group. In this randomized study, dTRA had lower RAO and PseA than pTRA. However, multicenter, larger-patient trials are needed to provide definitive evidence.
Keyphrases
- percutaneous coronary intervention
- coronary artery disease
- end stage renal disease
- st segment elevation myocardial infarction
- acute coronary syndrome
- acute myocardial infarction
- ejection fraction
- st elevation myocardial infarction
- chronic kidney disease
- antiplatelet therapy
- chronic pain
- newly diagnosed
- coronary artery bypass grafting
- aortic stenosis
- squamous cell carcinoma
- pain management
- heart failure
- coronary artery
- atrial fibrillation
- computed tomography
- patient reported outcomes
- clinical trial
- transcatheter aortic valve replacement
- spinal cord
- aortic valve replacement
- coronary artery bypass
- neural network
- patient reported