Department of Cardiology, Shenzhen Cardiovascular Minimally Invasive Medical Engineering Technology Research and Development Center, Shenzhen People's Hospital, The Second Clinical Medical College, Jinan University, Guangzhou, China.
The First Affiliated Hospital, Southern University of Science and Technology, Shenzhen 518020, Guangdong, China.
J Interv Cardiol. 2020 Dec 9;2020:4794838. doi: 10.1155/2020/4794838. eCollection 2020.
This prospective study compared the success rate and safety of a distal transradial artery (dTRA) approach to that of the conventional transradial artery (TRA) for coronary angiography or percutaneous coronary intervention.
From January 2019 to April 2020, nine hundred consecutive patients (height < 190 cm) scheduled for coronary angiography or percutaneous coronary interventions were randomly and equally assigned to receive either dTRA or conventional TRA catheterization.
Successful access was achieved in 96.00% and 96.67% of the dTRA and conventional TRA groups, respectively (=0.814). Compared with the TRA group, patients in the dTRA experienced significantly less hemostatic band removal time (150.5 ± 50.5 cf. 210.6 ± 60.5 min, =0.032); minor bleeding of the access site (2.44% cf. 6.44%, =0.038); hemostatic band cost (USD; 0.1 cf. 59.4, =0); and postprocedural radial artery occlusion (1.56% cf. 3.78%, =0.035). A lower body mass index was a higher risk factor for dTRA access failure (odds ratio = 0.79, =0.024), with a cutoff of 22.04 kg/m.
Compared to conventional TRA, dTRA had a comparable high success rate, with fewer associated complications. Clinicians should use the dTRA with caution in patients with low body mass index.
本前瞻性研究比较了远端桡动脉（dTRA）入路与传统桡动脉（TRA）入路行冠状动脉造影或经皮冠状动脉介入治疗的成功率和安全性。
2019 年 1 月至 2020 年 4 月，900 例连续拟行冠状动脉造影或经皮冠状动脉介入治疗的患者（身高<190cm）随机分为 dTRA 组和常规 TRA 组，分别接受 dTRA 或常规 TRA 导管插入术。
dTRA 组和常规 TRA 组的成功入路率分别为 96.00%和 96.67%（=0.814）。与 TRA 组相比，dTRA 组患者止血带去除时间明显缩短（150.5±50.5 分钟 vs. 210.6±60.5 分钟，=0.032）；穿刺部位轻度出血（2.44% vs. 6.44%，=0.038）；止血带费用（美元；0.1 美元 vs. 59.4 美元，=0）；术后桡动脉闭塞（1.56% vs. 3.78%，=0.035）。较低的体重指数是 dTRA 入路失败的更高风险因素（比值比=0.79，=0.024），截断值为 22.04kg/m。
与传统 TRA 相比，dTRA 成功率高，并发症少。对于 BMI 较低的患者，临床医生应谨慎使用 dTRA。
