Save the radial: go distally

Main Article Content

Rima Chaddad
Hussein Rabah
Batoul Awada
Malek Hmadeh

Abstract

Coronary artery disease is the leading cause of death worldwide.


Percutaneous coronary intervention (PCI) is one of the most widely performed medical procedures used to save lives, currently over 3 million annually worldwide.


The femoral artery has been the preferred vascular access site.


However, radial access is gaining extensive popularity due to the benefits of earlier ambulation, fewer access site complications, and decreased rates of bleeding.


Improvements in technology and understanding of the anatomic features of the vascular system have led to new insights into coronary angiography procedures.


Distal radial access, which was first used in 2017, shows a higher success rate and fewer complications than previous sites; therefore, it might be the future for cardiovascular intervention.


For this purpose, we conducted this prospective study at Beirut Cardiac Institute (BCI) comparing the two arms: radial vs. distal radial artery techniques through the anatomical snuffbox, in terms of patient’s length of stay, complication rate, and success rate of each procedure.

Article Details

Chaddad, R., Rabah, H., Awada, B., & Hmadeh, M. (2022). Save the radial: go distally. Journal of Cardiology and Cardiovascular Medicine, 7(1), 026–029. https://doi.org/10.29328/journal.jccm.1001128
Research Articles

Copyright (c) 2022 Chaddad R, et al.

Creative Commons License

This work is licensed under a Creative Commons Attribution 4.0 International License.

Helfrich CD, Tsai TT, Rao SV, Lemon JM, Eagenis EC, et al. Perceptions of advantages and barriers to radial access percutaneous coronary intervention in VA cardiac catheterization laboratories. Cardiovasc Revasc Med. 2014; 15: 329-333. PubMed: https://pubmed.ncbi.nlm.nih.gov/25282521/ DOI: https://doi.org/10.1016/j.carrev.2014.08.006

Amoroso G. Transradial approach for percutaneous coronary interventions: the future is now. Interventional Cardiol. 2013; 5: 279-288. DOI: https://doi.org/10.2217/ica.13.20

Archbold RA, Robinson NM, Schilling RJ. Radial artery access for coronary angiography and percutaneous coronary intervention. BMJ. 2004; 329: 443–446. PubMed: https://pubmed.ncbi.nlm.nih.gov/15321904/ DOI: https://doi.org/10.1136/bmj.329.7463.443

Kiemeneij F, Laarman GJ. Percutaneous transradial artery approach for coronary stent implantation. Catheter Cardiovasc Diagn. 1993; 30: 173–178. PubMed: https://pubmed.ncbi.nlm.nih.gov/8221875/ DOI: https://doi.org/10.1002/ccd.1810300220

Valgimigli M, Gagnor A, Calabró P, Frigoli E, Leonardi S, et al. Radial versus femoral accessin patients with acute coronary syndromes undergoing invasive management: a randomised multi-centre trial. Lancet. 2015; 385: 2465–2476. PubMed: https://pubmed.ncbi.nlm.nih.gov/25791214/ DOI: https://doi.org/10.1016/S0140-6736(15)60292-6

Lee CW, Cho SC. The Transradial Approach for Coronary Intervention: More Comfort, Better Outcome. Korean Circ J. 2018; 48: 728–730. PubMed: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6072665/ DOI: https://doi.org/10.4070/kcj.2018.0118

Nairoukh Z, Jahangir S, Adjepong D, Malik BH. Distal Radial Artery Access: The Future of Cardiovascular Intervention. Cureus. 2020; 12: e7201. PubMed: https://pubmed.ncbi.nlm.nih.gov/32269880/ DOI: https://doi.org/10.7759/cureus.7201

Sgueglia GA, Di Giorgio A, Gaspardone A, Babunashvili A. Anatomic Basis and Physiological Rationale of Distal Radial Artery Access for Percutaneous Coronary and Endovascular Procedures. JACC: Cardiovasc Interv. 2018; 11: 2113–2119. PubMed: https://pubmed.ncbi.nlm.nih.gov/30336816/

Corcos T. Distal radial access for coronary angiography and percutaneous coronary intervention: a state-of-the-art review. Catheter Cardiovasc Interv. 2019; 93: 639-644. PubMed: https://pubmed.ncbi.nlm.nih.gov/30536709/ DOI: https://doi.org/10.1002/ccd.28016

Sgueglia GA, Di Giorgio A, Gaspardone A, Babunashvili A. Anatomic basis and physiological rationale of distal radial artery access for percutaneous coronary and endovascular procedures. JACC Cardiovasc Interv. 2018; 11: 2113-2119. PubMed: https://pubmed.ncbi.nlm.nih.gov/30336816/ DOI: https://doi.org/10.1016/j.jcin.2018.04.045

Kaledin AL, Kochanov IN, Podmetin PS, Seletsky SS, Ardeev VN. Distal radial artery in endovascular interventions. ARYA Atheroscler. 2018; 14: 95-100.

Lee JW, Park SW, Son JW, Ahn SG, Lee SH. Real-world experience of the left distal transradial approach for coronary angiography and percutaneous coronary intervention: a prospective observational study (LeDRA). EuroIntervention. 2018; 14: e995-e1003. PubMed: https://pubmed.ncbi.nlm.nih.gov/30222122/ DOI: https://doi.org/10.4244/EIJ-D-18-00635

Ziakas A, Koutouzis M, Didagelos M, Tsiafoutis I, Kouparanis A, et al. Right arm distal transradial (snuffbox) access for coronary catheterization: Initial experience. Hellenic J Cardiol. 2020; 61: 106-109. PubMed: https://pubmed.ncbi.nlm.nih.gov/30389385/ DOI: https://doi.org/10.1016/j.hjc.2018.10.008

Aqel R, Alzughayyar T, Misk R. Radial: time to go distal. Cardiol Cardiovasc Med 2019; 3: 432-437. DOI: https://doi.org/10.26502/fccm.92920093

Hammami R, Zouari F, Ben Abdessalem MA, Sassi A, Ellouze T, et al. Distal radial approach versus conventional radial approach: a comparative study of feasibility and safety. Libyan J Med. 2021; 16: 1830600. PubMed: https://pubmed.ncbi.nlm.nih.gov/33147107/ DOI: https://doi.org/10.1080/19932820.2020.1830600

Asharaf T, Panhwar Z, Habib S, Memon MA, Shamsi F, et al. Size of radial and ulnar artery in local population. J Pak Med Assoc. 2010; 60: 817-819. PubMed: https://pubmed.ncbi.nlm.nih.gov/21381609/