SAFETY AND EFFICACY OF CORONARY INTERVENTION THROUGH DISTAL TRANSRADIAL  ACCESS IN SUBJECTS WITH LOW BODY MASS INDEX

K MAHMOOD; M BASHIR; M RAMZAN; O ADEEB

doi:10.54112/bcsrj.v2023i1.215

Authors

K MAHMOOD Department of Cardiology, Ch. Pervaiz Elahi Institute of Cardiology (CPEIC) Multan, Pakistan
M BASHIR Department of Cardiology, Ch. Pervaiz Elahi Institute of Cardiology (CPEIC) Multan, Pakistan
M RAMZAN Department of Cardiology, Ch. Pervaiz Elahi Institute of Cardiology (CPEIC) Multan, Pakistan
O ADEEB Department of Cardiology, Ch. Pervaiz Elahi Institute of Cardiology (CPEIC) Multan, Pakistan

DOI:

https://doi.org/10.54112/bcsrj.v2023i1.215

Keywords:

Distil transradial access, conventional transradial access, coronary intervention

Abstract

This study evaluated the efficacy and safety of coronary intervention through dTRA in subjects with low body mass index. The retrospective study was conducted in the Cardiology Department of Ch Pervaiz Elahi Institute of Cardiology Multan from January 2022 to January 2023. A total of 37 patients were included in the study. The patients were divided into Group A (cTRA, n=20) and Group B (dTRA, 17). Procedure-related information was recorded, including puncture time and success rate, procedural method and category, radiation exposure, compression hemostasis, and complications like degree of pain, hand swelling, numbness, hematoma, and bleeding. RAO was recorded in the follow-up. The puncture success rate in Group A was 97.5%, and in Group B was 96.7%; this difference was not statistically significant(P=.856). Group B had a longer puncture time than Group A (72s vs. the 60s, P=.003). 1 patient in group B had puncture failure and was switched to Group A. Procedural time in Group B was significantly longer than in Group A (46 min vs. 31 min, P=.043). Compression hemostasis time in Group B was significantly shorter than in Group A (5h vs. 7h, P<.001). The groups' differences in post-operative complications, including hand swelling, numbness, hematoma, and bleeding, were not statistically significant. However, Group B had a significantly lower VAS score than Group A (1 vs. 2, P=<.001). Based on the results, Distal transradial access provides an effective and safe route for coronary intervention in subjects with low BMI.

Downloads

Download data is not yet available.

References

Aykan, A. Ç., Hatem, E., Kalaycıoğlu, E., Altıntaş Aykan, D., Gökdeniz, T., Arslan, A. O., and Çelik, Ş. (2015). Prediction of radial artery diameter in candidates for transradial coronary angiography: is occupation a factor? Turk Kardiyol Dern Ars 43, 450-6.

Bajraktari, G., Rexhaj, Z., Elezi, S., Zhubi-Bakija, F., Bajraktari, A., Bytyci, I., Batalli, A., and Henein, M. Y. (2021). Radial access for coronary angiography carries fewer complications compared with femoral access: a meta-analysis of randomized controlled trials. Journal of Clinical Medicine 10, 2163.

Coughlan, J. J., Zebrauskaite, A., Arnous, S., and Kiernan, T. J. (2018). Left distal trans‐radial access facilitates earlier discharge post‐coronary angiography. Journal of Interventional Cardiology 31, 964-968.

Eid-Lidt, G., Rodríguez, A. R., Castellanos, J. J., Farjat Pasos, J. I., and Gaspar, J. (2021). Reply: Distal Radial Artery Approach to Prevent Radial Artery Occlusion. Cardiovascular Interventions 14, 1162-1163.

Garg, N., Madan, B., Khanna, R., Sinha, A., Kapoor, A., Tewari, S., Kumar, S., and Goel, P. K. (2015). Incidence and predictors of radial artery occlusion after transradial coronary angioplasty: Doppler-guided follow-up study. Journal of Invasive Cardiology 27.

Held, C., Hadziosmanovic, N., Aylward, P. E., Hagström, E., Hochman, J. S., Stewart, R. A., White, H. D., and Wallentin, L. (2022). Body Mass Index and Association With Cardiovascular Outcomes in Patients With Stable Coronary Heart Disease–A STABILITY Substudy. Journal of the American Heart Association 11, e023667.

Kormos, R. L., Antonides, C. F., Goldstein, D. J., Cowger, J. A., Starling, R. C., Kirklin, J. K., Rame, J. E., Rosenthal, D., Mooney, M. L., and Caliskan, K. (2020). Updated definitions of adverse events for trials and registries of mechanical circulatory support: a consensus statement of the mechanical circulatory support academic research consortium. The Journal of Heart and Lung Transplantation 39, 735-750.

Koutouzis, M., Kontopodis, E., Tassopoulos, A., Tsiafoutis, I., Katsanou, K., Rigatou, A., Didagelos, M., Andreou, K., Lazaris, E., and Oikonomidis, N. (2019). Distal versus traditional radial approach for coronary angiography. Cardiovascular Revascularization Medicine 20, 678-680.

Lee, J.-W., Park, S. W., Son, J.-W., Ahn, S.-G., and Lee, S.-H. (2018). Real-world experience of the left distal transradial approach for coronary angiography and percutaneous coronary intervention: a prospective observational study (LeDRA). EuroIntervention 14, e995-e1003.

Li, F., Shi, G.-W., Yu, X.-L., Song, R.-X., Xiao, J.-Q., Huang, H.-M., Li, L.-M., Zhang, L.-Y., Gong, C., and Cai, G.-J. (2022). 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. BMC Cardiovascular Disorders 22, 1-8.

Liang, C., Han, Q., Jia, Y., Fan, C., and Qin, G. (2021). Distal transradial access in anatomical snuffbox for coronary angiography and intervention: an updated meta-analysis. Journal of Interventional Cardiology 2021, 1-11.

Lin, Y., Sun, X., Chen, R., Liu, H., Pang, X., Chen, J., and Dong, S. (2020). Feasibility and safety of the distal transradial artery for coronary diagnostic or interventional catheterization. Journal of Interventional Cardiology 2020.

Lu, H., Wu, D., and Chen, X. (2020). Comparison of Distal Transradial Access in Anatomic Snuffbox Versus Transradial Access for Coronary Angiography. In "The Heart Surgery Forum", Vol. 23, pp. E407-E410.

Michael Schulte-Hermes, M., Oliver Klein-Wiele, M., Marc Vorpahl, M., and Melchior Seyfarth, M. (2018). Feasibility of transradial access for coronary interventions via percutaneous angioplasty of the radial artery in cases of functional radial occlusion. Journal of Invasive Cardiology 30.

Naito, T., Sawaoka, T., Sasaki, K., Iida, K., Sakuraba, S., Yokohama, K., Sato, H., Soma, M., Okamura, E., and Harada, T. (2019). Evaluation of the diameter of the distal radial artery at the anatomical snuff box using ultrasound in Japanese patients. Cardiovascular intervention and therapeutics 34, 312-316.

Norimatsu, K., Kusumoto, T., Yoshimoto, K., Tsukamoto, M., Kuwano, T., Nishikawa, H., Matsumura, T., and Miura, S.-i. (2019). Importance of measurement of the diameter of the distal radial artery in a distal radial approach from the anatomical snuffbox before coronary catheterization. Heart and Vessels 34, 1615-1620.

Rigatelli, G., Zuin, M., Daggubati, R., Vassilev, D., Zuliani, G., Nguyen, T., and Roncon, L. (2022). Distal snuffbox versus conventional radial artery access: an updated systematic review and meta-analysis. The Journal of Vascular Access 23, 653-659.

Rodrigues, A., Silva, M., Almeida, C., Ferreira, F. C., de Morais, G. P., Santos, L., Melica, B., and Braga, P. (2020). Same-day discharge after elective percutaneous coronary intervention: A single center experience. Revista Portuguesa de Cardiologia (English Edition) 39, 443-449.

Vefalı, V., and Sarıçam, E. (2020). The comparison of traditional radial access and novel distal radial access for cardiac catheterization. Cardiovascular Revascularization Medicine 21, 496-500.