Safety and efficacy of coronary angiography and percutaneous coronary intervention via distal transradial artery access in the anatomical snuffbox: a single-centre prospective cohort study using a propensity score method

Feng Li, Gan-Wei Shi, Xiao-Long Yu, Rui-Xiao Song, Jian-Qiang Xiao, Hao-Min Huang, La-Mei Li, Liu-Yan Zhang, Chun Gong, Gao-Jun Cai, Feng Li, Gan-Wei Shi, Xiao-Long Yu, Rui-Xiao Song, Jian-Qiang Xiao, Hao-Min Huang, La-Mei Li, Liu-Yan Zhang, Chun Gong, Gao-Jun Cai

Abstract

Background: This study investigated the safety and efficacy of coronary angiography (CAG) and percutaneous coronary intervention (PCI) via distal transradial artery access (d-TRA).

Methods: For this single-centre prospective cohort study, a total of 1066 patients who underwent CAG or PCI procedures from September 2019 to November 2020 were included. Patients were divided into two groups: the d-TRA group (346) and the conventional transradial artery access (c-TRA) group (720) based on access site. A total of 342 pairs of patients were successfully matched using propensity score matching (PSM) for subsequent analysis.

Results: No significant differences in puncture success rate, procedural method, procedural time, sheath size, contrast dosage or fluoroscopy time were noted between the two groups. The puncture time in the d-TRA group was longer than that in the c-TRA group (P < 0.01), and the procedure success rate was lower than that in the c-TRA group (90.94% vs. 96.49%, P = 0.01). The haemostasis time in the d-TRA group was shorter than that in the c-TRA group (P < 0.01), and the visual analogue scale (VAS) was lower than that in the c-TRA group (P < 0.01). In addition, the prevalence of bleeding and haematoma in the d-TRA group was lower than that in the c-TRA group (1.75% vs. 7.31%, P < 0.01; 0.58% vs. 3.22%, P = 0.01, respectively). No significant difference in the incidence of numbness was noted between the two groups. No other complications were found in two groups.

Conclusion: d-TRA is as safe and effective as c-TRA for CAG and PCI. It has the advantages of improved comfort and fewer complications. Trail registration Chinese Clinical Trial Registry, ChiCTR1900026519.

Keywords: Anatomical snuffbox; Coronary atherosclerotic disease; Distal transradial artery access; Percutaneous coronary intervention.

Conflict of interest statement

The authors declare that they have no competing interests.

© 2022. The Author(s).

Figures

Fig. 1
Fig. 1
Catheterization by d-TRA and c-TRA. A Implantation of the sheath via c-TRA. B Haemostasis of the c-TRA. C Implantation of the sheath via d-TRA. D Haemostasis of the d-TRA
Fig. 2
Fig. 2
Baseline characteristics before and after propensity score matching

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