Applicability of Distal Radial Artery Access in Acute Coronary Syndrome: A Single-Center Observational Registry Study
DOI:
https://doi.org/10.30701/ijc.2112Keywords:
acute coronary syndrome, angiography, cardiac catheterization, distal radial access, percutaneous coronary interventionAbstract
Background: Distal Radial Artery Access (DRA) has emerged as an alternative vascular access for Coronary Angiography (CGA) and Percutaneous Coronary Intervention (PCI). However, real-world data regarding its procedural feasibility and outcomes remain limited. This study aimed to evaluate the feasibility and procedural outcomes of distal radial artery access in patients undergoing CGA and/or PCI.
Methods: We conducted a single-center observational registry including consecutive patients undergoing CGA or PCI with an initial attempt at DRA access. The primary feasibility endpoint was successful completion of the procedure via DRA without crossover to an alternative vascular access site.
Results: A total of 835 patients were included in the analysis, representing an all-comer cohort including both Acute Coronary Syndrome (ACS) and Chronic Coronary Syndrome (CCS) presentations. The clinical indications included Non-ST-segment Elevation Myocardial Infarction (NSTEMI) in 326 patients (39%), Unstable Angina Pectoris (UAP) in 292 patients (35%), ST-segment Elevation Myocardial Infarction (STEMI) in 167 patients (20%), and stable coronary artery disease in 50 patients (6%). The primary feasibility endpoint, successful completion of the procedure via DRA without crossover, was achieved in 811 patients (97.1%). Crossover to an alternative access site occurred in 24 patients (2.9%), including contralateral proximal radial access in 13 patients (54.2%), femoral access in 10 patients (41.7%), and ipsilateral proximal radial access in 1 patient (4.2%).
Conclusions: DRA access demonstrated high procedural feasibility for CGA and PCI in a real-world cohort including both acute and CCS presentations.
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