Distal transradial versus conventional transradial access in acute coronary syndrome [Turk Kardiyol Dern Ars]
Turk Kardiyol Dern Ars. 2021; 49(4): 257-265 | DOI: 10.5543/tkda.2021.64000

Distal transradial versus conventional transradial access in acute coronary syndrome

Kenan Erdem1, Ertuğrul Kurtoğlu2, Mehmet Alparslan Küçük3, Tevfik Fikret İlgenli1, Muhammet Kızmaz4
1Department of Cardiology, Selçuk University School of Medicine, Konya, Turkey
2Department of Cardiology, Malatya Training and Research Hospital, Malatya, Turkey
3Department of Cardiology, Medova Hospital, Konya, Turkey
4Department of Family Medicine, Gemerek State Hospital, Sivas, Turkey


OBJECTIVE
Distal transradial access (TRA) has been recently introduced as an alternative access site for coronary angiography (CAG). Both procedures can be performed in cardiology clinics by interventional cardiologists. Although distal TRA is considered to be more difficult as it requires artery puncture and experienced cardiologists, it seems to be more advantageous because of the limited risk of arterial occlusion. In this study, we share our experiences with distal TRA and conventional TRA.

METHODS
Seventy patients undergoing CAG via distal TRA and 63 patients via conventional TRA were included in this study. The patients’ data were reviewed retrospectively and compared in terms of procedural characteristics and complications.

RESULTS
There was no significant difference between the distal TRA group (94.2%) and the conventional TRA group (98.4%) in terms of success rate (p=0.217). In the distal TRA group, the total sheath emplacement time was longer (p<0.001), and hemostasis time was shorter (p<0.001) compared with conventional TRA. Total procedural time and hospitalization period were not statistically different between the groups (p>0.05). Radial spasm and radial occlusion were more common in the conventional TRA group than in the distal TRA group (7.9% vs 1.4% and 3.1% vs 1.4%, respectively), and hematomas were not statistically different between the groups.

CONCLUSION
Although distal TRA seems more advantageous in terms of less hemostasis time and less vascular complications, it takes a longer time for sheath insertion and may cause more pain, which may diminish its efficiency. Large-scale studies are needed to address this issue.

Keywords: Coronary angiography, coronary artery disease, catheterization, brachial artery, radial artery, ulnar artery

How to cite this article
Kenan Erdem, Ertuğrul Kurtoğlu, Mehmet Alparslan Küçük, Tevfik Fikret İlgenli, Muhammet Kızmaz. Distal transradial versus conventional transradial access in acute coronary syndrome. Turk Kardiyol Dern Ars. 2021; 49(4): 257-265

Corresponding Author: Kenan Erdem, Türkiye
© Copyright 2021 Archives of the Turkish Society of Cardiology
LookUs & Online Makale