Reference Diameter and Characteristics of Distal Radial Artery by Ultrasonographic Assessement in Korean Patients

Radial access is recommended as the standard approach for coronary angiography (CAG) and percutaneous coronary intervention (PCI) based on the evidence in which RA reduced mortality and bleeding events compared with femoral access. Recently, the use of distal radial artery (DRA) is rapidly increasing in accordance with the publication of several studies that have shown easy hemostasis, reduced bleeding complications and low arterial occlusion rate via distal radial approach. However, the diameter of DRA is relatively smaller than radial artery (RA) which can limit the widespread use of this access route. Regarding the size discrepancy, there is a lack of evidence to guide which patients are acceptable or not for CAG and PCI. Therefore, the main purpose of this study was to provide the reference diameter of DRA using ultrasonography in Korean patients. The clinical predictors for small DRA also were evaluated.

Study Overview

• Status: Completed
• Conditions: Radial Artery
• Intervention / Treatment: Procedure: Ultrasonography

Detailed Description

Radial access is recommended as the standard approach for coronary angiography (CAG) and percutaneous coronary intervention (PCI) based on the evidence in which RA reduced mortality and bleeding events compared with femoral access. Recently, the use of distal radial artery (DRA) is rapidly increasing in accordance with the publication of several studies that have shown easy hemostasis, reduced bleeding complications and low arterial occlusion rate via distal radial approach. However, the diameter of DRA is relatively smaller than radial artery (RA) which can limit the widespread use of this access route. Regarding the size discrepancy, there is a lack of evidence to guide which patients are acceptable or not for CAG and PCI. Therefore, the main purpose of this study was to provide the reference diameter of DRA using ultrasonography in Korean patients. The clinical predictors for small DRA also were evaluated.

Assessment of arterial diameter by ultasonography Patients were lying on the bed with relaxation in an quiet room. The outer diameters of both DRA and RA were assessed by a perpendicular angle using a linear ultrasound probe (3-4-10.8 MHz) and the average values were recorded. The diameter of RA was measured from 2-3 cm above wrist crease. Anatomical landmark for the measurement of DRA was the bony surface area just distal space from extensor pollicis longus tendon in which the DRA was best palpable then runs down between the first metacarpal and second metacarpal bone (just out of anatomical snuffbox area)

• Study Type: Observational
• Enrollment (Actual): 1162

Contacts and Locations

Study Locations

• Korea, Republic of
  • Gangwon-do
    • Wonju, Gangwon-do, Korea, Republic of, 26426
      • Wonju Severance Christian Hospital

Participation Criteria

Eligibility Criteria

• Ages Eligible for Study: 20 years and older (ADULT, OLDER_ADULT)
• Accepts Healthy Volunteers: Yes
• Genders Eligible for Study: All

• Sampling Method: Non-Probability Sample

Study Population

Patients planned to perform transthoracic echocardiography with arterial ultrasonography were consecutively enrolled in a single center.

Description

Inclusion Criteria:

• Patients planned to perform transthoracic echocardiography with arterial ultrasonography

Exclusion Criteria:

• Age under 20-year
• Poor image quality
• repeated measurement

Study Plan

How is the study designed?

Number of groups / cohorts

2

Cohorts and Interventions

Group / Cohort	Intervention / Treatment
Male group; Male patients who performed transthoracic echocardiography with arterial ultrasonography	Procedure: Ultrasonography; The diameters of both the radial artery and the distal radial artery were measured by ultrasonography.
Female group; Female patients who performed transthoracic echocardiography with arterial ultrasonography	Procedure: Ultrasonography; The diameters of both the radial artery and the distal radial artery were measured by ultrasonography.

What is the study measuring?

Primary Outcome Measures

Outcome Measure	Measure Description	Time Frame
The diameter of distal radial artery	Mean diameter of distal radial artery on both left and right hand	Through ultrasonographic evaluation (within 1 hour)

Secondary Outcome Measures

Outcome Measure	Measure Description	Time Frame
The diameter of radial artery	Mean diameter of radial artery on both left and right hand	Through ultrasonographic evaluation (within 1 hour)
Arterial diameter index	Diameter of measure artery divided by body surface area	Through ultrasonographic evaluation (within 1 hour)
Proportion of small distal radial artery	Proportion of small distal radial artery (<2.3mm)	Through ultrasonographic evaluation (within 1 hour)
Predictor for small distal radial artery	Clinical predictor associated with small distal radial artery	Through ultrasonographic evaluation (within 1 hour)

Collaborators and Investigators

• Sponsor: Wonju Severance Christian Hospital
• Investigators: Principal Investigator: Jun-Won Lee, MD, PhD, Yonsei University Wonju College of Medicine, Wonju Severance Christian Hospital

Study record dates

Study Major Dates

• Study Start (ACTUAL): July 7, 2017
• Primary Completion (ACTUAL): April 13, 2018
• Study Completion (ACTUAL): February 29, 2020

Study Registration Dates

• First Submitted: March 9, 2020
• First Submitted That Met QC Criteria: March 9, 2020
• First Posted (ACTUAL): March 11, 2020

Study Record Updates

• Last Update Posted (ACTUAL): March 12, 2020
• Last Update Submitted That Met QC Criteria: March 10, 2020
• Last Verified: March 1, 2020

More Information

Terms related to this study

• Keywords: distal radial artery; radial artery; anatomical snuffbox
• Other Study ID Numbers: DRAUS

Drug and device information, study documents

• Studies a U.S. FDA-regulated drug product: No
• Studies a U.S. FDA-regulated device product: No