Interventional Cardiology and Structural Heart Disease, Texas A&M University College of Medicine, The Heart Hospital - Plano, Baylor Scott & White Health, 1100 Allied Dr, Plano, TX 75093, United States of America.
The Heart Hospital Plano - Baylor Scott & White, United States of America.
Cardiovasc Revasc Med. 2022 Feb;35:104-109. doi: 10.1016/j.carrev.2021.04.001. Epub 2021 Apr 15.
Radial artery (RA) catheterization is the access of choice over femoral artery access for most interventional vascular procedures given its safety and faster patient recovery. There has been growing interest in distal radial artery (dRA) access as an alternative to the conventional proximal radial artery (pRA) access. Preserving the RA is important which serves as a potential conduit for future coronary artery bypass surgery, dialysis conduit or preserve the artery for future cardiovascular procedures. The dRA runs in close proximity to the radial nerve, which raises the concern of potential detrimental effects on hand function.
The Distal versus Proximal Radial Artery Access for cardiac catheterization and intervention (DIPRA) trial is a prospective, randomized, parallel-controlled, open-label, single center study evaluating the outcomes of hand function and effectiveness of dRA compared to pRA access in patients undergoing cardiac catheterization. The eligible subjects will be randomized to dRA and pRA access in a (1:1) fashion. The primary end point is an evaluation of hand function at one and twelve months follow-up. Secondary end points include rates of access site hematoma, access site bleeding, other vascular access complications, arterial access success rate, and RA occlusion at one and twelve months follow up.
Effects of dRA on hand function remains unknown and it's use questionable in the presence of a widely accepted pRA. DIPRA trial is designed to determine the safety and effectiveness of dRA for diagnostic and interventional cardiovascular procedures compared to the standard of care pRA.
鉴于桡动脉（RA）通路的安全性和更快的患者康复，它已成为大多数介入血管程序的首选股动脉通路，而 RA 导管插入术则越来越受到关注。作为传统近侧 RA（pRA）通路的替代，远端 RA（dRA）通路的应用受到了越来越多的关注。保护 RA 很重要，因为它可以作为未来冠状动脉旁路移植术、透析导管或保留动脉以备未来心血管程序的潜在通道。dRA 与桡神经紧密相邻，这引起了对手部功能潜在有害影响的关注。
心脏导管插入术和介入治疗的远端与近端 RA 通路（DIPRA）试验是一项前瞻性、随机、平行对照、开放标签、单中心研究，评估了在接受心脏导管插入术的患者中，与 pRA 通路相比，dRA 通路对手部功能的影响和有效性。符合条件的受试者将以 1:1 的比例随机分为 dRA 和 pRA 通路。主要终点是在 1 个月和 12 个月随访时对手部功能进行评估。次要终点包括：穿刺部位血肿、穿刺部位出血、其他血管通路并发症、动脉通路成功率以及 1 个月和 12 个月随访时 RA 闭塞的发生率。
dRA 对手部功能的影响尚不清楚，在广泛接受的 pRA 存在的情况下，其使用存在疑问。DIPRA 试验旨在确定 dRA 在诊断和介入心血管程序中的安全性和有效性，与标准的 pRA 相比。
