Recently, a novel distal transradial, through anatomical snuffbox, approach has been proposed for undertaking percutaneous coronary angiography and interventions. The existing literature has evaluated distal transradial access (dTRA) as a feasible and safe approach, with faster hemostasis, lower rates of periprocedural complications and reduced incidence of radial artery occlusion (RAO). Aim of the present study is to compare dTRA versus conventional TRA access in patients with STEMI undergoing coronary angiography and interventions regarding peri- and post-procedural characteristics.
Gaining vascular access is the first, mandatory step for undertaking percutaneous coronary angiography and interventions. The recent guidelines, published by European Society of Cardiology (ESC), American College of Cardiology (ACC), American Heart Association (AHA) and Society for Cardiovascular Angiography and Interventions (SCAI), propose TRA as the gold standard for acute coronary syndromes (ACS), chronic coronary syndrome (CCS) percutaneous coronary interventions (PCI). Recently, a novel distal transradial, through anatomical snuffbox, approach has been proposed. The existing literature has evaluated distal transradial access (dTRA) as a feasible and safe approach, with faster hemostasis, lower rates of periprocedural complications and reduced incidence of radial artery occlusion (RAO). Mutual point of all the previous RCTs is that excluded patients suffering from ST-elevation Myocardial Infraction (STEMI). Aim of the present study is to compare dTRA versus conventional TRA access in patients with STEMI undergoing coronary angiography and interventions regarding peri- and post-procedural characteristics.
Study Type
INTERVENTIONAL
Allocation
RANDOMIZED
Purpose
TREATMENT
Masking
SINGLE
Enrollment
554
Coronary angiography +/- percutaneous coronary intervention
Department of Cardiology, Centre Hospitalier Universitaire de Charleroi
Charleroi, Belgium
RECRUITINGUniversity Hospital of Patras
Pátrai, Greece
RECRUITINGDepartment of Cardiology, Geneva University Hospitals, Geneva, Switzerland.
Geneva, Switzerland
RECRUITINGneedle-to-wire time
needle-to-wire time
Time frame: Immediately post-procedurally
Radial artery occlusion using Doppler examination prior to hospital discharge
Radial artery patency evaluation with Doppler ultrasound prior to hospital discharge for detecting possible occlusion after cannulation
Time frame: The evaluation will be performed during hospitalization for STEMI and prior discharge, typically the 4th day after PCI
Access site crossover rate
Crossover rate from distal transradial artery access to other access point
Time frame: Immediately post-procedurally
Sheath insertion time
Duration required from the beginning of puncture until sheath insertion
Time frame: Immediately post-procedurally
Total procedure time
Total duration of coronary angiography and angioplasty
Time frame: Immediately post-procedurally
The time interval between the initiation of radial artery puncture and the completion of coronary angiography, until the beginning of the possible PCI
The time interval between the initiation of radial artery puncture and the completion of coronary angiography, until the beginning of the possible PCI
Time frame: Immediately post-procedurally
Required time for coronary angiography completion, after sheath insertion
Required time for coronary angiography completion, after sheath insertion
Time frame: Immediately post-procedurally
Required time percutaneous coronary intervention completion
Required time percutaneous coronary intervention completion
Time frame: Immediately post-procedurally
Total fluoroscopy time
Total fluoroscopy time
Time frame: Immediately post-procedurally
Total Dose Area Product (DAP)
Total Dose Area Product (DAP)
Time frame: Immediately post-procedurally
Air Kerma
Air Kerma
Time frame: Immediately post-procedurally
Hemostasis time
Time required for achieving hemostasis
Time frame: 3 hours
Vascular complications
Vascular complications
Time frame: 24 hours
Hematomas classification (modified EASY classification)
Hematomas classification using modified EASY which is compatible with dTRA
Time frame: 24 hours
30-days Clinical follow-up (on site or via telephone call)
30-days Clinical follow-up (on site or via telephone call)
Time frame: 30 days
This platform is for informational purposes only and does not constitute medical advice. Always consult a qualified healthcare professional.