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Published in: BMC Cardiovascular Disorders 1/2020

Open Access 01-12-2020 | Angiography | Review

Distal transradial access: a review of the feasibility and safety in cardiovascular angiography and intervention

Authors: Gaojun Cai, Haomin Huang, Feng Li, Ganwei Shi, Xiaolong Yu, Lei Yu

Published in: BMC Cardiovascular Disorders | Issue 1/2020

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Abstract

Background

Transradial access (TRA) has been considered as the default choice in cardiac catheterization. Although infrequent, vascular complications of this approach remain. Recently, the distal transradial approach (dTRA) in cardiac catheterization was reported by interventionalists.

Methods

We retrieved the relevant literatures and reviewed the safety and feasibility of this novel approach in cardiac catheterization.

Results

The dTRA for cardiac intervention has superior safety and satisfaction. As a novel approach for cardiac catheterization, access related complications should also be considered by operators, such as RAO, radial spasm, bleeding and haematoma, and injury of the superficial branch of the radial nerve.

Conclusions

The dTRA in cardiovascular angiography and intervention was safe and feasible.
Literature
1.
go back to reference Bajaj A, Pancholy S, Sothwal A, Nawaz Y, Boruah P. Transradial versus Transfemoral access for percutaneous coronary intervention of unprotected left Main coronary artery stenosis: a systematic review and meta-analysis. Cardiovasc Revasc Med. 2019, 20(9):790–798. doi:https://doi.org/10.1016/j.carrev.2018.10.025. PMID: 30442537. Bajaj A, Pancholy S, Sothwal A, Nawaz Y, Boruah P. Transradial versus Transfemoral access for percutaneous coronary intervention of unprotected left Main coronary artery stenosis: a systematic review and meta-analysis. Cardiovasc Revasc Med. 2019, 20(9):790–798. doi:https://​doi.​org/​10.​1016/​j.​carrev.​2018.​10.​025. PMID: 30442537.
2.
go back to reference Ferrante G, Rao SV, Jüni P, Da Costa BR, Reimers B, Condorelli G, Anzuini A, Jolly SS, Bertrand OF, Krucoff MW, Windecker S, Valgimigli M. Radial versus femoral access for coronary interventions across the entire spectrum of patients with coronary artery disease: a meta-analysis of randomized trials. JACC Cardiovasc Interv, 2016, 9 (14): 1419–1434. doi: https://doi.org/10.1016/j.jcin.2016.04.014. PMID: 27372195. Ferrante G, Rao SV, Jüni P, Da Costa BR, Reimers B, Condorelli G, Anzuini A, Jolly SS, Bertrand OF, Krucoff MW, Windecker S, Valgimigli M. Radial versus femoral access for coronary interventions across the entire spectrum of patients with coronary artery disease: a meta-analysis of randomized trials. JACC Cardiovasc Interv, 2016, 9 (14): 1419–1434. doi: https://​doi.​org/​10.​1016/​j.​jcin.​2016.​04.​014. PMID: 27372195.
3.
go back to reference Valgimigli M, Frigoli E, Leonardi S, Vranckx P, Rothenbühler M, Tebaldi M, Varbella F, Calabrò P, Garducci S, Rubartelli P, Briguori C, Andó G, Ferrario M, Limbruno U, Garbo R, Sganzerla P, Russo F, Nazzaro M, Lupi A, Cortese B, Ausiello A, Ierna S, Esposito G, Ferrante G, Santarelli A, Sardella G, de Cesare N, Tosi P, van't van’t Hof A, Omerovic E, Brugaletta S, Windecker S, Heg D, Jüni P. MATRIX Investigators. Radial versus femoral access and bivalirudin versus unfractionated heparin in invasively managed patients with acute coronary syndrome (MATRIX): final 1-year results of a multicentre, randomised controlled trial. Lancet. 2018, 392: 835–848. doi: https://doi.org/10.1016/S0140-6736(18)31714-8. PMID: 30153988. Valgimigli M, Frigoli E, Leonardi S, Vranckx P, Rothenbühler M, Tebaldi M, Varbella F, Calabrò P, Garducci S, Rubartelli P, Briguori C, Andó G, Ferrario M, Limbruno U, Garbo R, Sganzerla P, Russo F, Nazzaro M, Lupi A, Cortese B, Ausiello A, Ierna S, Esposito G, Ferrante G, Santarelli A, Sardella G, de Cesare N, Tosi P, van't van’t Hof A, Omerovic E, Brugaletta S, Windecker S, Heg D, Jüni P. MATRIX Investigators. Radial versus femoral access and bivalirudin versus unfractionated heparin in invasively managed patients with acute coronary syndrome (MATRIX): final 1-year results of a multicentre, randomised controlled trial. Lancet. 2018, 392: 835–848. doi: https://​doi.​org/​10.​1016/​S0140-6736(18)31714-8. PMID: 30153988.
4.
go back to reference Neumann FJ, Sousa-Uva M, Ahlsson A, Alfonso F, Banning AP, Benedetto U, Byrne RA, Collet JP, Falk V, Head SJ, Jüni P, Kastrati A, Koller A, Kristensen SD, Niebauer J, Richter DJ, Seferović PM, Sibbing D, Stefanini GG, Windecker S, Yadav R, Zembala MO. ESC/ EACTS Guidelines on myocardial revascularization. Eur Heart J 2018, 40: 87–165. doi: https://doi.org/10.4244/EIJY19M01_01. PMID: 30667361. Neumann FJ, Sousa-Uva M, Ahlsson A, Alfonso F, Banning AP, Benedetto U, Byrne RA, Collet JP, Falk V, Head SJ, Jüni P, Kastrati A, Koller A, Kristensen SD, Niebauer J, Richter DJ, Seferović PM, Sibbing D, Stefanini GG, Windecker S, Yadav R, Zembala MO. ESC/ EACTS Guidelines on myocardial revascularization. Eur Heart J 2018, 40: 87–165. doi: https://​doi.​org/​10.​4244/​EIJY19M01_​01. PMID: 30667361.
6.
go back to reference Fernandez R, Zaky F, Ekmejian A, Curtis E, Lee A. Safety and efficacy of ulnar artery approach for percutaneous cardiac catheterization: systematic review and meta-analysis. Catheter Cardiovasc Interv, 2018, 91 (7): 1273–1280. DOI: https://doi.org/10.1002/ccd.27479. PMID: 29388387. Fernandez R, Zaky F, Ekmejian A, Curtis E, Lee A. Safety and efficacy of ulnar artery approach for percutaneous cardiac catheterization: systematic review and meta-analysis. Catheter Cardiovasc Interv, 2018, 91 (7): 1273–1280. DOI: https://​doi.​org/​10.​1002/​ccd.​27479. PMID: 29388387.
10.
go back to reference Gasparini GL, Garbo R, Gagnor A, Oreglia J, Mazzarotto P. Feasibility and safety of distal radial access for percutaneous coronary intervention using a 7 FR sheath. Catheter Cardiovasc Interv 2019, 94(6):902. doi: https://doi.org/10.1002/ccd.28397. PMID: 31328326. Gasparini GL, Garbo R, Gagnor A, Oreglia J, Mazzarotto P. Feasibility and safety of distal radial access for percutaneous coronary intervention using a 7 FR sheath. Catheter Cardiovasc Interv 2019, 94(6):902. doi: https://​doi.​org/​10.​1002/​ccd.​28397. PMID: 31328326.
11.
go back to reference Kim Y, Jeong MH, Kim I, Kim MC, Sim DS, Hong YJ, Kim JH, Ahn Y. Intravascular ultrasound-guided percutaneous coronary intervention with drug-eluting stent for unprotected left Main disease via left snuffbox approach. Korean Circ J. 2018, 48(6):532–533. doi: https://doi.org/10.4070/kcj.2018.0016. PMID: 29856149. Kim Y, Jeong MH, Kim I, Kim MC, Sim DS, Hong YJ, Kim JH, Ahn Y. Intravascular ultrasound-guided percutaneous coronary intervention with drug-eluting stent for unprotected left Main disease via left snuffbox approach. Korean Circ J. 2018, 48(6):532–533. doi: https://​doi.​org/​10.​4070/​kcj.​2018.​0016. PMID: 29856149.
15.
go back to reference Schulte-Hermes M, Klein-Wiele O, Vorpahl M, Seyfarth M. Feasibility of Transradial access for coronary interventions via percutaneous angioplasty of the radial artery in cases of functional radial occlusion. J Invasive Cardiol. 2018;30(10):355–9. 30108190.PubMed Schulte-Hermes M, Klein-Wiele O, Vorpahl M, Seyfarth M. Feasibility of Transradial access for coronary interventions via percutaneous angioplasty of the radial artery in cases of functional radial occlusion. J Invasive Cardiol. 2018;30(10):355–9. 30108190.PubMed
18.
go back to reference Rashid M, Kwok CS, Pancholy S, Chugh S, Kedev SA, Bernat I, Ratib K, Large A, Fraser D, Nolan J, Mamas MA. Radial artery occlusion after Transradial interventions: a systematic review and meta-analysis. J Am Heart Assoc 2016, 5(1):e002686. doi: https://doi.org/10.1161/JAHA.115.002686. PMID: 26811162. Rashid M, Kwok CS, Pancholy S, Chugh S, Kedev SA, Bernat I, Ratib K, Large A, Fraser D, Nolan J, Mamas MA. Radial artery occlusion after Transradial interventions: a systematic review and meta-analysis. J Am Heart Assoc 2016, 5(1):e002686. doi: https://​doi.​org/​10.​1161/​JAHA.​115.​002686. PMID: 26811162.
20.
go back to reference Babunashvili A, Dundua D. Recanalization and reuse of early occluded radial artery within 6 days after previous transradial diagnostic procedure. Catheter Cardiovasc Interv 2011, 77(4):530–536. doi: https://doi.org/10.1002/ccd.22846. PMID: 20939038. Babunashvili A, Dundua D. Recanalization and reuse of early occluded radial artery within 6 days after previous transradial diagnostic procedure. Catheter Cardiovasc Interv 2011, 77(4):530–536. doi: https://​doi.​org/​10.​1002/​ccd.​22846. PMID: 20939038.
23.
go back to reference Valsecchi O, Vassileva A, Cereda AF, Canova P, Satogami K, Fiocca L, Guagliumi G. Early clinical experience with right and left distal Transradial access in the anatomical snuffbox in 52 consecutive patients. J Invasive Cardiol. 2018, 30(6):218–223. PMID: 29543187. Valsecchi O, Vassileva A, Cereda AF, Canova P, Satogami K, Fiocca L, Guagliumi G. Early clinical experience with right and left distal Transradial access in the anatomical snuffbox in 52 consecutive patients. J Invasive Cardiol. 2018, 30(6):218–223. PMID: 29543187.
24.
go back to reference Kim Y, Ahn Y, Kim I, Lee DH, Kim MC, Sim DS, Hong YJ, Kim JH, Jeong MH. Feasibility of coronary angiography and percutaneous coronary intervention via left snuffbox approach. Korean Circ J. 2018, 48(12):1120–1130. doi: https://doi.org/10.4070/kcj.2018.0181. PMID: 30088362. Kim Y, Ahn Y, Kim I, Lee DH, Kim MC, Sim DS, Hong YJ, Kim JH, Jeong MH. Feasibility of coronary angiography and percutaneous coronary intervention via left snuffbox approach. Korean Circ J. 2018, 48(12):1120–1130. doi: https://​doi.​org/​10.​4070/​kcj.​2018.​0181. PMID: 30088362.
25.
go back to reference 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(9):e995-e1003. doi: https://doi.org/10.4244/EIJ-D-18-00635. PMID: 30222122. 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(9):e995-e1003. doi: https://​doi.​org/​10.​4244/​EIJ-D-18-00635. PMID: 30222122.
29.
go back to reference Flores EA. Making the right move: use of the distal radial artery access in the hand for coronary angiography and percutaneous coronary interventions. Cath Lab Digest. 2018;26(12):16–25 www.cathlabdigest.com. Flores EA. Making the right move: use of the distal radial artery access in the hand for coronary angiography and percutaneous coronary interventions. Cath Lab Digest. 2018;26(12):16–25 www.​cathlabdigest.​com.
30.
go back to reference Mizuguchi Y, Izumikawa T, Hashimoto S, Yamada T, Taniguchi N, Nakajima S, Hata T, Takahashi A. Efficacy and safety of the distal transradial approach in coronary angiography and percutaneous coronary intervention: a Japanese multicenter experience. Cardiovasc Interv Ther. 2019. 31127474. https://doi.org/10.1007/s12928-019-00590-0. Mizuguchi Y, Izumikawa T, Hashimoto S, Yamada T, Taniguchi N, Nakajima S, Hata T, Takahashi A. Efficacy and safety of the distal transradial approach in coronary angiography and percutaneous coronary intervention: a Japanese multicenter experience. Cardiovasc Interv Ther. 2019. 31127474. https://​doi.​org/​10.​1007/​s12928-019-00590-0.
31.
34.
go back to reference Uddin MJ, Hashem S, Momen A, Sarker S, Rahman AU, Hasan M, Saha BP, Mozumder MR, Shahriar MS. Right distal radial artery access for coronary intervention initial experience in Bangladesh. J Am Coll Cardiol. 2019;73(15 Supplement):S72.CrossRef Uddin MJ, Hashem S, Momen A, Sarker S, Rahman AU, Hasan M, Saha BP, Mozumder MR, Shahriar MS. Right distal radial artery access for coronary intervention initial experience in Bangladesh. J Am Coll Cardiol. 2019;73(15 Supplement):S72.CrossRef
35.
go back to reference Amin MR, Banerjee SK, Biswas E, Paul N, Mahabub EE, Ahmed SF, Banerjee RS, Singha CK. Feasibility and safety of distal Transradial access in the anatomical snuffbox for coronary angiography and intervention. Mymensingh Med J. 2019;28(3):647–54. 31391439.PubMed Amin MR, Banerjee SK, Biswas E, Paul N, Mahabub EE, Ahmed SF, Banerjee RS, Singha CK. Feasibility and safety of distal Transradial access in the anatomical snuffbox for coronary angiography and intervention. Mymensingh Med J. 2019;28(3):647–54. 31391439.PubMed
44.
go back to reference Mori S, Ito Y, Kishida T, Fukagawa T, Shirai S, Makino K, Honda Y, Tsutsumi M, Sakamoto Y, Kobayashi N, Araki M, Yamawaki M, Hirano K. A comparison of feasibility and safety using transradial versus distal transradial approach in patients undergoing coronary angiography and percutaneous coronary intervention. JACC. 2019;73(9):1259 Poster.CrossRef Mori S, Ito Y, Kishida T, Fukagawa T, Shirai S, Makino K, Honda Y, Tsutsumi M, Sakamoto Y, Kobayashi N, Araki M, Yamawaki M, Hirano K. A comparison of feasibility and safety using transradial versus distal transradial approach in patients undergoing coronary angiography and percutaneous coronary intervention. JACC. 2019;73(9):1259 Poster.CrossRef
49.
go back to reference Kim Y, Jeong MH, Kim MC, Sim DS, Hong YJ, Kim JH, Ahn Y. Successful percutaneous coronary intervention with two-stent technique for unprotected true left Main bifurcation lesion via left snuffbox approach. J Invasive Cardiol. 2019;31(3):E55. 30819983.PubMed Kim Y, Jeong MH, Kim MC, Sim DS, Hong YJ, Kim JH, Ahn Y. Successful percutaneous coronary intervention with two-stent technique for unprotected true left Main bifurcation lesion via left snuffbox approach. J Invasive Cardiol. 2019;31(3):E55. 30819983.PubMed
52.
go back to reference Skraqi E, Kis M, Akin M. Endothelial functions are preserved in left distal radial access coronary angiography, a prospective comparison with right and left forearm radial artery access site. Eur Heart J. 2018;39(suppl_1):ehy566–P6371.CrossRef Skraqi E, Kis M, Akin M. Endothelial functions are preserved in left distal radial access coronary angiography, a prospective comparison with right and left forearm radial artery access site. Eur Heart J. 2018;39(suppl_1):ehy566–P6371.CrossRef
54.
go back to reference Koutouzis M, Kontopodis E, Tassopoulos A, Tsiafoutis I, Lazaris E. Hand hematoma after cardiac catheterization via distal radial artery. J Invasive Cardiol. 2018;30(11):428. 29921745.PubMed Koutouzis M, Kontopodis E, Tassopoulos A, Tsiafoutis I, Lazaris E. Hand hematoma after cardiac catheterization via distal radial artery. J Invasive Cardiol. 2018;30(11):428. 29921745.PubMed
56.
go back to reference Amin MR, Singha CK, Banerjee SK, Hoque H, Mahabub SEE, Hoque M, Biswas E. Comparison of distal transradial in the anatomical suffbox versus conventional transradial access for coronary angiography and intervention- an experience in 100 cases. Univ Heart J. 2017;13(2):40–5.CrossRef Amin MR, Singha CK, Banerjee SK, Hoque H, Mahabub SEE, Hoque M, Biswas E. Comparison of distal transradial in the anatomical suffbox versus conventional transradial access for coronary angiography and intervention- an experience in 100 cases. Univ Heart J. 2017;13(2):40–5.CrossRef
66.
go back to reference Nardai S, Végh E, Óriás V, Nemes B, Tóth J, Hüttl A, Hüttl K, Avantadil B, Bertrand OF, Merkely B, Ruzsa Z. Feasibility of distal radial access for carotid interventions: the RADCAR-DISTAL pilot study. EuroIntervention. 2019. pii: EIJ-D-19-00023. doi: https://doi.org/10.4244/EIJ-D-19-00023. Nardai S, Végh E, Óriás V, Nemes B, Tóth J, Hüttl A, Hüttl K, Avantadil B, Bertrand OF, Merkely B, Ruzsa Z. Feasibility of distal radial access for carotid interventions: the RADCAR-DISTAL pilot study. EuroIntervention. 2019. pii: EIJ-D-19-00023. doi: https://​doi.​org/​10.​4244/​EIJ-D-19-00023.
Metadata
Title
Distal transradial access: a review of the feasibility and safety in cardiovascular angiography and intervention
Authors
Gaojun Cai
Haomin Huang
Feng Li
Ganwei Shi
Xiaolong Yu
Lei Yu
Publication date
01-12-2020
Publisher
BioMed Central
Keyword
Angiography
Published in
BMC Cardiovascular Disorders / Issue 1/2020
Electronic ISSN: 1471-2261
DOI
https://doi.org/10.1186/s12872-020-01625-8

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