Interventional Cardiology, Instituto Nacional de Cardiología Ignacio Chávez, Mexico City, Mexico.
Interventional Cardiology, Instituto Nacional de Cardiología Ignacio Chávez, Mexico City, Mexico.
JACC Cardiovasc Interv. 2021 Feb 22;14(4):378-385. doi: 10.1016/j.jcin.2020.10.013.
The aim of this study was to compare the rate of proximal radial artery occlusion (RAO) with Doppler ultrasound between distal and conventional radial access 24 h and 30 days after a transradial coronary procedure.
The use of distal radial access to prevent proximal RAO (PRAO) in the proximal segment at 24 h and 30 days after a procedure, compared with conventional radial access, is unknown.
This was a prospective, comparative, longitudinal, randomized study. A total of 282 patients were randomized to either proximal radial access (n = 142) or distal radial access (n = 140) to evaluate the superiority of the distal approach in the prevention of PRAO with Doppler ultrasound 24 h and 30 days after a transradial coronary procedure.
In the per protocol analysis, the rates of PRAO at 24 h and 30 days were 8.4% and 5.6% in the proximal group and 0.7% and 0.7% in the distal group, respectively (24 h: odds ratio [OR]: 12.8; 95% confidence interval [CI]: 1.6 to 100.0; p = 0.002; 30 days: OR: 8.2; 95% CI: 1.0 to 67.2; p = 0.019). In an intention-to-treat analysis, the 24-h and 30-day rates of PRAO were 8.8% and 6.4% for proximal radial access and 1.2% and 0.6% in the distal radial access group (24 h: OR: 7.4; 95% CI: 1.6 to 34.3; p = 0.003; 30 days: OR: 10.6; 95% CI: 1.3 to 86.4; p = 0.007).
Distal radial access prevents RAO in the proximal segment at 24 h and 30 days after the procedure compared with conventional radial access.
本研究旨在比较经桡动脉入路（TRA）行冠状动脉介入治疗（PCI）后 24 小时和 30 天近端桡动脉闭塞（RAO）的发生率，使用多普勒超声评估远端桡动脉入路与传统桡动脉入路的差异。
与传统桡动脉入路相比，在 TRA 后 24 小时和 30 天近端桡动脉节段使用远端桡动脉入路预防近端 RAO（PRAO）的效果尚不清楚。
这是一项前瞻性、对比、纵向、随机研究。共 282 例患者随机分为近端桡动脉入路组（n=142）和远端桡动脉入路组（n=140），使用多普勒超声评估 TRA 后 24 小时和 30 天远端桡动脉入路预防 PRAO 的优势。
在符合方案分析中，近端组和远端组 24 小时和 30 天 PRAO 的发生率分别为 8.4%和 5.6%，0.7%和 0.7%（24 小时：比值比[OR]：12.8；95%置信区间[CI]：1.6 至 100.0；p=0.002；30 天：OR：8.2；95%CI：1.0 至 67.2；p=0.019）。意向治疗分析中，近端桡动脉入路组 24 小时和 30 天 PRAO 的发生率分别为 8.8%和 6.4%，远端桡动脉入路组分别为 1.2%和 0.6%（24 小时：OR：7.4；95%CI：1.6 至 34.3；p=0.003；30 天：OR：10.6；95%CI：1.3 至 86.4；p=0.007）。
与传统桡动脉入路相比，远端桡动脉入路可预防 TRA 后 24 小时和 30 天近端桡动脉节段的 RAO。
