• Tao Chen, Lamei Li, Feng Li, Wei Lu, Ganwei Shi, Wenhua Li, Anni Yang, Hui Huang, Jianqiang Xiao, Qiuwei Zhang, Jun Gu, Sheliang Xue, Liuyan Zhang, Li Li, Lingxia Xu, Rongrong Ji, Haibo Wang, and Gaojun Cai.
• Department of Cardiology, Wujin Hospital Affiliated With Jiangsu University, The Wujin Clinical College of Xuzhou Medical University, Changzhou, 213017, Jiangsu Province, China.
• Bmc Med. 2024 Feb 8; 22 (1): 6262.

BackgroundThe distal transradial access (dTRA) has become an attractive and alternative access to the conventional transradial access (TRA) for cardiovascular interventional diagnosis and/or treatment. There was a lack of randomized clinical trials to evaluate the effect of the dTRA on the long-term radial artery occlusion (RAO).MethodsThis was a prospective, randomized controlled study. The primary endpoint was the incidence of long-term RAO at 3 months after discharge. The secondary endpoints included the successful puncture rate, puncture time, and other access-related complications.ResultsThe incidence of long-term RAO was 0.8% (3/361) for dTRA and 3.3% (12/365) for TRA (risk ratio = 0.25, 95% confidence interval = 0.07-0.88, P = 0.02). The incidence of RAO at 24 h was significantly lower in the dTRA group than in the TRA group (2.5% vs. 6.7%, P < 0.01). The puncture success rate (96.0% vs. 98.5%, P = 0.03) and single puncture attempt (70.9% vs. 83.9%, P < 0.01) were significantly lower in the dTRA group than in the TRA group. However, the number of puncture attempts and puncture time were higher in the dTRA group. The dTRA group had a lower incidence of bleeding than the TRA group (1.5% vs. 6.0%, P < 0.01). There was no difference in the success rate of the procedure, total fluoroscopy time, or incidence of other access-related complications between the two groups. In the per-protocol analysis, the incidence of mEASY type ≥ II haematoma was significantly lower in the dTRA group, which was consistent with that in the as-treated analysis.ConclusionsThe dTRA significantly reduced the incidence of long-term RAO, bleeding or haematoma.Trial RegistrationClinicalTrials.gov identifer: NCT05253820.© 2024. The Author(s).

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